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Total knee replacements using rotating hinge implants in polio patients: clinical and functional outcomes
V Digennaro1, M Manzetti2, B D Bulzacki Bogucki3
1IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
Musculoskeletal Surgery
|August 10, 2022
Summary
Total knee replacement (TKR) using rotating hinge knee (RHK) prostheses significantly improves function in polio patients with severe knee issues. This study highlights RHK as a successful option for enhancing mobility and quality of life.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Biomedical Engineering
Background:
- Limited data exists on total knee replacement (TKR) outcomes for poliomyelitis patients with severe knee deformities.
- Constrained implants, specifically rotating hinge knee (RHK) prostheses, show promise compared to less constrained options.
Purpose of the Study:
- To evaluate the functional results, complications, and survival rates of RHK total knee replacement in poliomyelitis patients.
- To assess the efficacy of RHK prostheses in addressing severe knee deformities and degeneration post-poliomyelitis.
Main Methods:
- Retrospective chart review of 14 poliomyelitis patients (15 TKRs) who underwent primary RHK implantation.
- Preoperative and postoperative assessment using Knee Society Score (KSS), hip-knee angle, recurvatum knee angle, and Insall-Salvati index.
Main Results:
- Significant improvement in clinical Knee Society Scores (KSS) from 32.9 to 77.4 (P < 0.005) at 2 years post-surgery.
- Marked enhancement in functional KSS, increasing from 32.5 to 59.4 (P < 0.005).
- Radiographic parameters like hip-knee angle and recurvatum knee angle showed improvement post-TKR.
Conclusions:
- Total knee replacement with RHK prostheses is an effective treatment for improving knee function and quality of life in poliomyelitis patients.
- RHK implants offer a viable alternative for polio patients with quadriceps weakness, aiding in maintaining knee kinematics and reducing instability-related revisions.
