Salvage revision total knee replacement using the Endo-Model rotating hinge prosthesis.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Complex revision total knee replacement (TKR) often presents challenges with joint stability and balance.
• Rotating hinged knee (RHK) devices are utilized as a salvage procedure for these challenging cases.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of the Endo-Model rotating hinge prosthesis in complex revision TKR.
• To assess patient satisfaction and functional improvement following salvage revision surgery.

Main Methods:

• Retrospective study of 51 Endo-Model RHK prostheses in 50 patients undergoing revision TKR.
• Average follow-up of 4 years, with review of clinical and radiological results.
• Assessment using the Hospital for Special Surgery (HSS) score and patient satisfaction questionnaires.

Main Results:

• Significant improvements in pain, stability, range of motion, and mobility were observed (HSS score improved from 35.9 to 72.17).
• 86% of patients were satisfied with the outcome; satisfaction was higher in cases of aseptic loosening (95%) compared to infection (74%).
• Common reasons for revision included infection (23) and aseptic loosening (23), with an average of three prior surgeries per patient.

Conclusions:

• The Endo-Model RHK prosthesis demonstrates encouraging short-to-medium term results as a salvage procedure in selected complex revision TKR cases.
• Combining objective scores (HSS) with subjective patient satisfaction is crucial for evaluating complex salvage revision knee surgery.
• Revision TKR for infection yields less satisfactory outcomes compared to revision for aseptic loosening.