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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

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The Management of Extensive Bone Loss in Primary and Revision Total Knee Replacement

Silvestris Zebolds / Valdis Goncars / Ints Zommers / Konstantins Kalnberzs
Published Online: 2013-05-11 | DOI: https://doi.org/10.2478/v10163-012-0007-7


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.

Keywords : severe gonarthrosis; Rotating-Hinge endoprosthesis; semi-constraint

  • 1. Engelbrecht E., Nieder E., Klüber. D. Reconstruction of the Knee - Ten to Twenty Years of Knee Arthroplasty at the Endo-Klinik: A Report on the Long-term Follow-up of the St. Georg Hinge and the Medium-term Follow-up of the Rotating Knee Endo-Model // Springer Verlag, 1996: 186-199; Google Scholar

  • 2. Hofmann, S. Kim C. Bertin. Design LCCk1. IC TKA // Primary and Revision Brochures and Presentations. Stolzalpe, May and June 2009; Google Scholar

  • 3. Lombardi, A.V. Jr. Surgical Technique with the Link Endo-Model Rotational Knee System (Non- modular) // Booklet. Pinebrook, NJ: Link Orthopaedics Total Joint Systems, April 2000; Google Scholar

  • 4. Lombardi A. V., Mallory Th. H., Eberle Ro. W., Adams Jo. B. Results of Revision Total Knee Arthroplasty Using Constrained Prostheses // Seminars in Arthroplasty, Vol. 7, No. 4 (October), pp. 349-355, 1996; Google Scholar

  • 5. Lombardi, A.V. Jr.; Mallory, T.H.; Eberle R.W.; Adams, J.B. Rotating hinge prosthesis in revision total knee arthroplasty: Indications and results. // Surgical Technology International VI. San Francisco: Universal Medical Press, Inc., pp.379-382, 1997; Google Scholar

  • 6. Nieder E., Engelbrecht E., Keller A., Klüber D., Friesecke C. Rotationsknieprothese Endo- Modell Mittelfristige Ergebnisse von 1837 Fällen in der primären Kniealloarthroplastik // Wissenschaftl. Ausstellung während des 20. SICOTWeltkongresses, 18.-23. August 1996; Google Scholar

  • 7. Petrou G., Petrou H., Tilkeridis C., Stavrakis T., Kapetsis T., Kremmidas N., Gavras M. Medium-term results with a primary cemented rotating-hinge total knee replacement: A 7-to 15-year follow-up // J Bone Joint Surg., 2004; 86-B: 813-817; Google Scholar

  • 8. Pietsch, M. Hofmann, S. The difficult primary TKA. IC TKA Primary and Revision // Brochures and Presentations. Stolzalpe, May and June 2009; Google Scholar

  • 9. Seitlinger, G. Hofmann, S. Bone defects. IC TKA Primary and Revision // Brochures and Presentations. Stolzalpe, May and June 2009; Google Scholar

  • 10. Utting M.R., Newman J.H. Customised hinged knee replacement as a salvage procedure for failed total knee arthroplasty // The Knee, 2004; 11: 475-479.PubMedGoogle Scholar

About the article

Published Online: 2013-05-11

Published in Print: 2012-12-01

Citation Information: Acta Chirurgica Latviensis, Volume 12, Issue 1, Pages 32–35, ISSN (Print) 1407-981X, DOI: https://doi.org/10.2478/v10163-012-0007-7.

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