Skip to main content
SpringerLink
Log in

Protesi totali di ginocchio vincolate

Hinged total knee arthroplasties

  • Aggiornamenti
  • Published:
LO SCALPELLO-OTODI Educational

Abstract

Rotating-hinge knee implants are used for revision total knee arthroplasty in patients with severe ligament instability and bone loss. They have been available since the 1970s as an improvement of fixed-hinge models. At present, hinged implants are generally used for revision total knee arthroplasty (TKA). They can also be used for primary TKA, but some authors suggest that this type of prosthesis is associated with a greater risk of aseptic loosening because of increased stress to the bone-prosthesis interface.

We analysed our experience regarding these kinds of implants. We performed one study on a group of Endo-modell (Lima) and another study on Nexgen RHK (Zimmer) as revision implants. We also performed a study on a group of Endo-modell used as primary implants.

Rotating-hinge knee implants provided acceptable mid-term outcomes for revision knee surgery with ligamentous instability. The HSS-KS results showed statistically significant improvements from the preoperative to the postoperative evaluations, average ROM increased and average pain was lower than in the preoperative status.

Usually, the high percentage of failure is related to surgery complexity and to patient status rather than to the hinged mechanism. The use of this implant is recommended for revision total knee arthroplasty, especially in patients with severe instability and bone loss. In the group of RHK for primary implant, the overall failure rate was higher than that of unhinged implants; therefore, this prosthesis is recommended for cases of instability and revision rather than primary knee arthroplasty.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Bibliografia

  1. Barrack RL (2001) Evolution of the rotating hinge for complex total knee arthroplasty. Clin Orthop Relat Res 392:292–299

    Article  Google Scholar 

  2. Pour AE, Parvizi J, Slenker N et al. (2007) Rotating hinged total knee replacement: use with caution. J Bone Jt Surg Am 89(8):1735–1741

    Google Scholar 

  3. Springer BD, Hanssen AD, Sim FH et al. (2001) The kinematic rotating hinge prosthesis for complex knee arthroplasty. Clin Orthop Relat Res 392:283–291

    Article  Google Scholar 

  4. Guenoun B, Latargez L, Freslon M et al. (2009) Complications following rotating hinge Endo-Modell (Link) knee arthroplasty. Orthop Traumatol Surg Res 95(7):529–536

    Article  CAS  PubMed  Google Scholar 

  5. Petrou G, Petrou H, Tilkeridis C et al. (2004) Medium-term results with a primary cemented rotating-hinge total knee replacement. A 7- to 15-year follow-up. J Bone Jt Surg Br 86(6):813–817

    Article  CAS  Google Scholar 

  6. Bistolfi A, Rosso F, Crova M, Massazza G (2013) Endo-Modell rotating-hinge total knee for revision total knee arthroplasty. Orthopedics 36(10):e1299–e1306

    Article  PubMed  Google Scholar 

  7. Bistolfi A, Massazza G, Rosso F, Crova M (2012) Rotating-hinge total knee for revision total knee arthroplasty. Orthopedics 35(3):e325–e330

    PubMed  Google Scholar 

  8. Bistolfi A, Lustig S, Rosso F et al. (2013) Results with 98 Endo-Modell rotating hinge prostheses for primary knee arthroplasty. Orthopedics 36(6):e746–e752

    Article  PubMed  Google Scholar 

  9. Joshi N, Navarro-Quilis A (2008) Is there a place for rotating-hinge arthroplasty in knee revision surgery for aseptic loosening? J Arthroplast 23:1204–1211

    Article  Google Scholar 

  10. Bistolfi A, Turell MB, Lee YL, Bellare A (2009) Tensile and tribological properties of high-crystallinity radiation crosslinked UHMWPE. J Biomed Mater Res B, Appl Biomater 90(1):137–144

    Google Scholar 

Download references

Ringraziamenti

Gli autori sono profondamente grati al Prof. Maurizio Crova per i cuoi insuperati insegnamenti in chirurgia del ginocchio.

Author information

Authors and Affiliations

  1. Orthopaedics and Traumatology, CTO trauma centre, AO Città della Salute e della Scienza, via Zuretti 29, 10126, Torino, Italia

    Alessandro Bistolfi, Ferdinando Tosto, Francesco Lagalla, Luigi Sabatini, Eugenio Graziano, Elvio Novarese & Alessandro Massè

Authors
  1. Alessandro Bistolfi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ferdinando Tosto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Francesco Lagalla
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Luigi Sabatini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eugenio Graziano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elvio Novarese
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alessandro Massè
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alessandro Bistolfi.

Ethics declarations

Conflitto di interesse

Gli autori Alessandro Bistolfi, Ferdinando Tosto, Francesco Lagalla, Luigi Sabatini, Eugenio Graziano, Elvio Novarese e Alessandro Massè dichiarano di non avere alcun conflitto di interesse.

Consenso informato e conformità agli standard etici

Tutte le procedure descritte nello studio e che hanno coinvolto esseri umani sono state attuate in conformità alle norme etiche stabilite dalla dichiarazione di Helsinki del 1975 e successive modifiche. Il consenso informato è stato ottenuto da tutti i pazienti inclusi nello studio.

Human and Animal Rights

L’articolo non contiene alcuno studio eseguito su esseri umani e su animali da parte degli autori.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bistolfi, A., Tosto, F., Lagalla, F. et al. Protesi totali di ginocchio vincolate. LO SCALPELLO 31, 168–172 (2017). https://doi.org/10.1007/s11639-017-0207-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11639-017-0207-y

Search

Navigation