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Implant survival and outcome after rotating-hinge total knee revision arthroplasty: a minimum 6-year follow-up

  • Knee Revision Surgery
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Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Data on long-time survival and clinical function of rotating hinge knee prostheses used in revision total knee arthroplasty (TKA) are scarce.

Method

We evaluate the outcome of 42 revision TKA in 38 patients using the Endo-model rotating hinge total knee prosthesis after a minimum of 6 years, with 10-year implant survival as our primary outcome measure. Only revision TKAs performed due to aseptic loosening were included, and the Swedish Knee Arthroplasty Register was consulted in order to ensure that patients unavailable for clinical follow-up had not been revised elsewhere. Mean follow-up was after 8.8 (6–18) years, mean age at revision surgery was 72 (55–88) years, and most patients had severe medical comorbidities (n = 31).

Results

At follow-up, four knees had been re-revised due to aseptic loosening, and five further knees underwent re-revision due to other reasons. With implant revision due to aseptic loosening as the endpoint, 10-year survival was 89.2%, and with implant revision due to any reason 10-year survival was 65.1%. 11 patients (13 knees) eligible for clinical follow-up were evaluated according to the Hospital for Special Surgery score (HSSS), the Knee Society scores (KSS), and by plain radiography. Mean HSSS was 67 (36–90), mean KSS-knee was 85 (73–96), and mean KSS-function was 29 (0–100). Radiography showed that no implant was in need of revision.

Conclusion

Our results indicate that revision arthroplasty of the knee with this rotating hinge prosthesis can be performed with satisfactory or good results in an elderly population with severe comorbidities.

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Acknowledgments

We thank the Swedish Knee Arthroplasty Register and especially Dr Otto Robertsson for providing information on the patients included in this study. Institutional support has been provided to NPH by Link Sweden AB, Åkersberga, Sweden. The company named above has not been involved in the study design, data collection, data interpretation, or manuscript preparation.

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Authors and Affiliations

  1. Department of Orthopaedics, Institute for Surgical Sciences, Uppsala University Hospital, 751 85, Uppsala, Sweden

    Asgeir Gudnason, Jan Milbrink & Nils P. Hailer

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  1. Asgeir Gudnason
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Correspondence to Nils P. Hailer.

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Gudnason, A., Milbrink, J. & Hailer, N.P. Implant survival and outcome after rotating-hinge total knee revision arthroplasty: a minimum 6-year follow-up. Arch Orthop Trauma Surg 131, 1601–1607 (2011). https://doi.org/10.1007/s00402-011-1330-5

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