An Individualized Design Approach for Revising Total Knee Hinges
Revision knee replacement is becoming an increasingly frequent problem in contemporary knee surgery because of the many primary cases and the long followup of the earlier and often less successful designs. Various implants for revision knee surgery have become available. Revision condylar-type replacements, semiconstrained hinged implants, and constrained hinged implants are all currently being employed for revision knee surgery [1–3]. Each of these prostheses attempts to address the surgical problems regarding revision, including massive loss of bone and ligamentous instability. The surgeon can select an appropriate prosthesis for each patient and each particular situation according to the bone loss and ligamentous stability encountered. Revising a condylar replacement usually presents few problems. However, revision of failed hinges frequently involves considerable loss of bone, instability, bone fractures, and infection. We reviewed cases in which revision was done one, two, or three times to determine the indications for a new revision strategy.
KeywordsFemoral Component Tibial Component High Tibial Osteotomy Ultrahigh Molecular Weight Polyethylene Intramedullary Fixation
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