[Hinge prosthesis of the knee. Apropos of 185 cases]

On hundred and ninety-five hinge prostheses have been inserted between 1970 and 1981, most of them of the G.U.E.P.A.R. type. One hundred and forty-three were followed up. The etiology of five per-operative deaths is discussed. It is concluded that this dramatic event was related to gas embolism. Precautions necessary to avoid such accidents are described particularly at the time of release of the tourniquet. There were 11 cases of sepsis, eight loosenings and four post-operative fractures of the femur or tibia. The functional results were found to be satisfactory but better with the G.U.E.P.A.R. type than with the Shiers prosthesis. Most of the post-operative pain originated from the patella; this aspect of the pain should be able to be avoided by systematic use of patellar resurfacing. The authors conclude that a hinge prosthesis should be used only in cases of severe deformity, of severe instability or in cases of failure of resurfacing procedures.