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Acta Chirurgica Latviensis
The Journal of Riga Stradins University; Latvian Association of Surgeons; Latvian Association of Paediatric Surgeons
2 Issues per year
The Management of Extensive Bone Loss in Primary and Revision Total Knee Replacement
Introduction. Total knee replacement (TKR) is still a challenging procedure for severe gonarthrosis patients. Deformities of knee joint (varus, valgus - more than 30 degrees), insufficiency of collateral ligaments and extensive bone loss could be a difficult problem to solve with standard knee endoprosthesis. Also in cases of revision - TKR the restoration of bone loss and regaining of stability of the joint could be a problem.
Aim of the Study. The aim of our study was to analyse the results with Rotating - Hinge prosthesis after severe primary and revision TKR.
Materials and Methods. 34 patients (27 female, 7 male) were treated with Rotating - Hinge prosthesis during 12 years (first in 1997). Mean age of patients were 69 years. 17 operations were primary total knee arthroplasties and also 17 were revisions of the knee prosthesis. The Oxford Knee score was used for evaluation of patients satisfaction rate. The Knee Society Score was used to get objective functional results. For radiological analysis X-rays of knee joint in two projections were performed.
Results. 34 Oxford Knee score questionnaires were sent to patients, response we got from 27 patients (79%). Mean result from Oxford Knee score was 32 which is good. The same number of patients (34) were invited for examination using Knee Society score. The response were from 20 patients (59%). Mean result from Knee Society score was 83, which means excellent.
Conclusions. Rotating-Hinge prosthesis allows to achieve good and excellent functional results and high patients satisfaction rate after severe primary and revision TKR. The biological age, general health condition, insufficiency of ligaments and previous infection in patients history have to be considered for choosing the tactics for each case.