Good Clinical and Radiological Results of Total Knee Arthroplasty Using Varus Valgus Constrained or Rotating Hinge Implants in Ligamentous Laxity

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2018 Nov 21

PMID 30456570

Citations 6

Authors

Eric Rohner

Kathrin Benad

Timo Zippelius

Nadja Kloss

Benjamin Jacob

Julia Kirschberg

Georg Matziolis

Affiliations

Soon will be listed here.

Abstract

Purpose: The optimal degree of constraint of a total knee arthroplasty for treatment of knee osteoarthritis with ligamentous laxity is under debate. While varus valgus constrained knees require a minimum level of ligamentous stability, rotating hinge knees can even be implanted if the collateral ligaments have been lost completely. It seems plausible that joint kinematics are determined by implant design in rotating hinge knees, whereas varus valgus constrained knees may be influenced by remaining stabilizers. This may result in more predictable clinical results of hinge knees. The hypothesis of the present study, therefore, was that stability and clinical outcome are better after total knee arthroplasty using rotating hinge knees than after using varus valgus constrained knees.

Methods: All patients who were treated using a mobile-bearing varus valgus constrained knee or a rotating hinge knee for treatment of end-stage osteoarthritis and ligamentous laxity were included. At follow-up, clinical scores were determined (WOMAC, VAS, KSS, FJS, Lysholm). Furthermore, body mass index, operating time, and postoperative complications were documented. Whole leg radiographs as well as patella axial radiographs were analyzed for implant alignment and patella tracking.

Results: Eighty-five patients were included in this retrospective study. Both groups showed an average range of motion of 113°. No significant difference between the two groups was observed for any of the scores recorded. In the rotating hinge knee group, a more precise tibia positioning in relation to the mechanical axis but also a significant lateralisation and tilting of the patella were seen, compared with the varus valgus constrained knee group.

Conclusions: Rotating hinge knees did not perform better than mobile-bearing varus valgus constrained knees clinically. Both prosthesis types showed equally good clinical outcomes with regard to stability, mobility, satisfaction, pain and operating time.

Level Of Evidence: Retrospective case series, Level IV.

Citing Articles

Good Mid-Term Implant Survival of a Novel Single-Design Rotating-Hinge Total Knee Arthroplasty.

Schlechter M, Theil C, Gosheger G, Moellenbeck B, Schwarze J, Puetzler J J Clin Med. 2023; 12(19).

PMID: 37834758 PMC: 10573219. DOI: 10.3390/jcm12196113.

Clinical Outcomes of Repair of Complete Detachment of Medial Collateral Ligament at the Tibial Insertion in Bilateral Total Knee Arthroplasty.

Jin C, Song E, Jin Q, Seon J, Sun S Evid Based Complement Alternat Med. 2022; 2022:7266233.

PMID: 35911142 PMC: 9334065. DOI: 10.1155/2022/7266233.

Long Term Results of a Rotating Hinge Total Knee Prosthesis With Carbon-Fiber Reinforced Poly-Ether-Ether-Ketone (CFR-PEEK) as Bearing Material.

Vertesich K, Staats K, Bohler C, Koza R, Lass R, Giurea A Front Bioeng Biotechnol. 2022; 10:845859.

PMID: 35356773 PMC: 8959897. DOI: 10.3389/fbioe.2022.845859.

Prostheses option in revision total knee arthroplasty, from the bench to the bedside: (1) basic science and principles.

Zhang J, Li E, Zhang Y EFORT Open Rev. 2022; 7(2):174-187.

PMID: 35192509 PMC: 8897564. DOI: 10.1530/EOR-21-0089.

Outcomes of the rotating hinge knee in revision total knee arthroplasty with a median follow-up of 6.2 years.

Von Hintze J, Niemelainen M, Sintonen H, Nieminen J, Eskelinen A BMC Musculoskelet Disord. 2021; 22(1):336.

PMID: 33827526 PMC: 8028074. DOI: 10.1186/s12891-021-04205-9.

References

Springer B, Hanssen A, Sim F, Lewallen D . The kinematic rotating hinge prosthesis for complex knee arthroplasty. Clin Orthop Relat Res. 2001; (392):283-91. DOI: 10.1097/00003086-200111000-00037. View

Sharkey P, Hozack W, Rothman R, Shastri S, Jacoby S . Insall Award paper. Why are total knee arthroplasties failing today?. Clin Orthop Relat Res. 2002; (404):7-13. DOI: 10.1097/00003086-200211000-00003. View

Naudie D, Rorabeck C . Managing instability in total knee arthroplasty with constrained and linked implants. Instr Course Lect. 2004; 53:207-15. View

Petrou G, Petrou H, Tilkeridis C, Stavrakis T, Kapetsis T, Kremmidas N . Medium-term results with a primary cemented rotating-hinge total knee replacement. A 7- to 15-year follow-up. J Bone Joint Surg Br. 2004; 86(6):813-7. DOI: 10.1302/0301-620x.86b6.14708. View

Morgan H, Battista V, Leopold S . Constraint in primary total knee arthroplasty. J Am Acad Orthop Surg. 2005; 13(8):515-24. DOI: 10.5435/00124635-200512000-00004. View

Lachiewicz P, Soileau E . Ten-year survival and clinical results of constrained components in primary total knee arthroplasty. J Arthroplasty. 2006; 21(6):803-8. DOI: 10.1016/j.arth.2005.09.008. View

Lombardi Jr A, Berend K, Leith J, Mangino G, Adams J . Posterior-stabilized constrained total knee arthroplasty for complex primary cases. J Bone Joint Surg Am. 2007; 89 Suppl 3:90-102. DOI: 10.2106/JBJS.G.00586. View

Mavrodontidis A, Andrikoula S, Kontogeorgakos V, Babis G, Xenakis T, Beris A . Application of the Endomodel rotating hinge knee prosthesis for knee osteoarthritis. J Surg Orthop Adv. 2008; 17(3):179-84. View

Guenoun B, Latargez L, Freslon M, Defossez G, Salas N, Gayet L . Complications following rotating hinge Endo-Modell (Link) knee arthroplasty. Orthop Traumatol Surg Res. 2009; 95(7):529-36. DOI: 10.1016/j.otsr.2009.07.013. View

10.

Hernandez-Vaquero D, Sandoval-Garcia M . Hinged total knee arthroplasty in the presence of ligamentous deficiency. Clin Orthop Relat Res. 2010; 468(5):1248-53. PMC: 2853658. DOI: 10.1007/s11999-009-1226-7. View

11.

Yang J, Yoon J, Oh C, Kim T . Primary total knee arthroplasty using rotating-hinge prosthesis in severely affected knees. Knee Surg Sports Traumatol Arthrosc. 2011; 20(3):517-23. DOI: 10.1007/s00167-011-1590-1. View

12.

Baker P, Critchley R, Gray A, Jameson S, Gregg P, Port A . Mid-term survival following primary hinged total knee replacement is good irrespective of the indication for surgery. Knee Surg Sports Traumatol Arthrosc. 2012; 22(3):599-608. DOI: 10.1007/s00167-012-2305-y. View

13.

Long R, Gheduzzi S, Bucher T, Toms A, Miles A . A biomechanical evaluation of hinged total knee replacement prostheses. Proc Inst Mech Eng H. 2013; 227(8):875-83. DOI: 10.1177/0954411913488506. View

14.

Bistolfi A, Lustig S, Rosso F, Dalmasso P, Crova M, Massazza G . Results with 98 Endo-Modell rotating hinge prostheses for primary knee arthroplasty. Orthopedics. 2013; 36(6):e746-52. DOI: 10.3928/01477447-20130523-19. View

15.

Gehrke T, Kendoff D, Haasper C . The role of hinges in primary total knee replacement. Bone Joint J. 2014; 96-B(11 Supple A):93-5. DOI: 10.1302/0301-620X.96B11.34143. View

16.

Lombardi Jr A, Berend K, Adams J . Why knee replacements fail in 2013: patient, surgeon, or implant?. Bone Joint J. 2014; 96-B(11 Supple A):101-4. DOI: 10.1302/0301-620X.96B11.34350. View

17.

Thiele K, Perka C, Matziolis G, Mayr H, Sostheim M, Hube R . Current failure mechanisms after knee arthroplasty have changed: polyethylene wear is less common in revision surgery. J Bone Joint Surg Am. 2015; 97(9):715-20. DOI: 10.2106/JBJS.M.01534. View

18.

Malcolm T, Bederman S, Schwarzkopf R . Outcomes of Varus Valgus Constrained Versus Rotating-Hinge Implants in Total Knee Arthroplasty. Orthopedics. 2016; 39(1):e140-8. DOI: 10.3928/01477447-20151228-07. View

19.

Feng X, Yang C, Fu D, Ye S, Liu X, Chen Z . Mid-term outcomes of primary constrained condylar knee arthroplasty for severe knee deformity. J Huazhong Univ Sci Technolog Med Sci. 2016; 36(2):231-236. DOI: 10.1007/s11596-016-1572-0. View

20.

Martin J, Beahrs T, Stuhlman C, Trousdale R . Complex Primary Total Knee Arthroplasty: Long-Term Outcomes. J Bone Joint Surg Am. 2016; 98(17):1459-70. DOI: 10.2106/JBJS.15.01173. View