Is there a place for rotating-hinge arthroplasty in knee revision surgery for aseptic loosening?

We reviewed the results of 78 revision total knee arthroplasties using a rotating-hinge device, performed from 1993 through 2002. The average follow-up was 7.83 years. Only patients requiring revision arthroplasty due to aseptic loosening were included. Reasons for revision were malalignment with or without polyethylene wear (47), instability (24), extensor mechanism failure (3), and periprosthetic fracture (4). The mean preoperative scores according to the American Knee Society rating scale was 37.5 points for knee score and 32.8 points for function score. Postoperatively, the knee score improved to 85.7 points and the function score improved to 61.4 points. Nineteen patients had complications related to the design prostheses (mostly minor complications). Fifty-seven patients (73%) had excellent results, with a range of motion of 104 degrees in flexion and complete extension. For extreme circumstances, such as gross instability of the medial collateral ligament, massive bone loss, comminuted fracture, and chronic dysfunction of the extensor mechanism, there is a place for hinged revision implant surgery with good clinical results and quality of life.