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Rotating platform components for revisions of hinged knee prostheses
Bertram Barden1, Josef G Fitzek, Franz Löer
1Department of Orthopaedic Surgery, St. Augustinus Hospital, Duren, Germany. bbarden.sak-dn@clinet.de
Clinical Orthopaedics and Related Research
|July 3, 2004
Summary
Revision of hinged knee prostheses to rotating platform revision prostheses with bone grafting demonstrates successful fixation and restoration of function. This approach effectively addresses failed hinged implants, improving patient outcomes and joint stability.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Reconstructive Surgery
Background:
- Hinged knee prostheses can fail, necessitating revision surgery.
- Revision with smaller, non-hinged implants presents challenges in achieving adequate fixation and restoring biomechanics.
Purpose of the Study:
- To evaluate the success of revising failed hinged knee prostheses to rotating platform revision prostheses.
- To assess implant fixation, bone stock reinforcement, ligamentous stability, and extensor mechanism function after revision.
Main Methods:
- Prospective study of 20 patients revising failed hinged prostheses to rotating platform revision prostheses with short intramedullary stems.
- Utilized meticulous soft tissue release and extensive bone grafting (impaction and structural grafts) for tibia and femur.
- Mean follow-up of 5.3 years.
Main Results:
- Significant improvement in The Knee Society score (mean 21 to 81.2).
- 95% of components achieved excellent fixation, with successful bone graft remodeling and union.
- Restored ligamentous stability and avoided extensor mechanism complications.
Conclusions:
- Rotating platform revision prostheses are a successful option for failed hinged knee prostheses.
- The combination of these prostheses with bone grafting provides durable fixation and restores joint function.
- This technique offers a viable solution for complex knee revision cases.