Jump to ContentJump to Main Navigation
Show Summary Details
In This Section

Acta Chirurgica Latviensis

The Journal of Riga Stradins University; Latvian Association of Surgeons; Latvian Association of Paediatric Surgeons

2 Issues per year

Open Access
Online
ISSN
2199-5737
See all formats and pricing
In This Section

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

Silvestris Zebolds
  • Corresponding author
  • Hospital of Traumatology and Orthopaedics, Riga, Latvia
  • Riga Stradins University, Riga, Latvia
  • Email:
/ Valdis Goncars
  • Hospital of Traumatology and Orthopaedics, Riga, Latvia
/ Ints Zommers
  • University of Latvia, Riga, Latvia
/ Konstantins Kalnberzs
  • Hospital of Traumatology and Orthopaedics, Riga, Latvia
  • University of Latvia, Riga, Latvia
Published Online: 2013-05-11 | DOI: https://doi.org/10.2478/v10163-012-0007-7

Summary

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;

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

  • 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;

  • 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;

  • 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;

  • 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;

  • 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;

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

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

  • 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. [PubMed]

About the article

Published Online: 2013-05-11

Published in Print: 2012-12-01



Citation Information: Acta Chirurgica Latviensis, ISSN (Print) 1407-981X, DOI: https://doi.org/10.2478/v10163-012-0007-7. Export Citation

This content is open access.

Comments (0)

Please log in or register to comment.
Log in