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Knee Joint

Knee Joint

The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...

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The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report

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Rotating Hinge Implants for Complex Primary and Revision Total Knee Arthroplasty.

Sean M Kearns¹, Brian M Culp¹, Daniel D Bohl¹

¹Department of Orthopaedics, Rush University Medical Center, Chicago, Illinois.

The Journal of Arthroplasty

|November 14, 2017

Summary

Modern rotating hinge knee (RHK) implants show improved survival but still have high complication rates in complex knee replacements. Further data is needed for these challenging primary and revision cases.

Keywords:

complications primary knee arthroplasty revision knee arthroplasty rotating hinge total knee

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Area of Science:

Orthopedic surgery
Biomedical engineering
Arthroplasty

Background:

Contemporary rotating hinge knee (RHK) prostheses demonstrate enhanced survival over previous designs.
High complication and mechanical failure rates necessitate further clinical outcome data, particularly in complex primary and revision total knee arthroplasty (TKA).

Purpose of the Study:

To report clinical outcomes and complication rates of a contemporary RHK implant in complex primary and revision TKA.
To evaluate the efficacy and safety of RHK in challenging surgical scenarios.

Main Methods:

A prospectively maintained database identified 79 knees (76 patients) undergoing RHK for complex primary (14) or revision (65) TKA.
Outcomes were assessed using Knee Society Scores, with radiographic review for wear and loosening. Kaplan-Meier survival curves estimated failure rates.

Main Results:

Mean follow-up was 55.2 months for 62 knees (59 patients). Knee Society Scores improved significantly (35.7 to 66.2, P < .01).
Overall complication incidence was 38.7%, including periprosthetic fracture, extensor mechanism rupture, and infection. Estimated 5-year survival was 70.7%.

Conclusions:

Modern RHK implants, despite design improvements, are associated with a substantial complication rate in complex TKA.
Periprosthetic fracture, infection, and extensor mechanism failure are significant concerns, underscoring the complexity of these revision and primary cases.