Salvage of failed hinge knee arthroplasty with a Total Condylar III type prosthesis

Fourteen failed aseptic-hinge total-knee arthroplasties (TKA) were reviewed to determine if an unlinked metal to plastic Total Condylar III type prosthesis can be used for salvage procedure. The overall preoperative Hospital for Special Surgery knee-rating score was 58 and improved to 81 post-operatively. The average postrevision range of motion was 83 degrees. The soft tissue sleeve, the built-in constraint of the prosthesis, and the restoration of the bone deficiency provided good stability, despite the loss of the collateral and cruciate ligaments. Radiolucent lines, less than 1 mm in width and incomplete, appeared in four femoral and ten tibial bone-cement interfaces. In one femoral component there was a 2-mm radiolucency with a cement fracture at the femoral stem tip. There were no failures or repeated revisions, but two knees required postoperative manipulation to improve motion. Total Condylar III type prosthesis can be satisfactorily used to salvage failed hinge TKA.