Endo-Modell rotating-hinge total knee for revision total knee arthroplasty

The goal of this study was to analyze the clinical and radiographic results and the survival rate of a series of rotating-hinge implants used for revision total knee arthroplasties in mild and severe instability. Between December 1991 and June 2004, fifty-three revision total knee arthroplasties were performed using the Endo-Modell (Waldemar LINK GmbH and Co, Hamburg, Germany) rotating-hinge prosthesis; 7 (13.2%) patients underwent partial revision of a previous Endo-Modell. All patients were evaluated preoperatively, 3 and 6 months postoperatively, and annually thereafter using the Hospital for Special Surgery (HSS) knee score and the Knee Society Roentgenographic Evaluation System (KS-RES). Mean follow-up was 155.2±40.1 months (range, 78-240 months), with 32 patients examined at the final follow-up. All HSS knee scores increased from preoperatively to last follow-up. No statistically significance differences were found in the HSS knee scores between septic and aseptic revisions and between total or partial revisions. Progressive radiolucent lines were detected in 8 (25%) patients. Implant failure occurred in 11 (20.7%) patients; the cumulative survival of the implants was 80.4% at 150 months for the final 32 patients. The authors recommend use of this implant for revision total knee arthroplasty, especially in patients with severe instability and bone loss.