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Hinge total knee replacement revisited

H U Cameron1, C Hu, D Vyamont

  • 1Department of Surgery, University of Toronto, Ont.

Canadian Journal of Surgery. Journal Canadien De Chirurgie
|August 1, 1997
PubMed
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Aseptic loosening is uncommon in hinge total knee replacement, with only 7% of patients experiencing this complication. However, overall complication rates remain high for these complex cases.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Hinge total knee replacement (TKR) is indicated for severe knee instability.
  • Assessing the incidence of aseptic loosening is crucial for understanding implant survival.
  • The Guepar II prosthesis is a type of constrained hinge implant.

Purpose of the Study:

  • To evaluate the frequency of aseptic loosening as a complication in hinge TKR.
  • To determine the overall complication rate associated with hinge TKR.
  • To review the indications and outcomes of hinge TKR.

Main Methods:

  • A cohort study was conducted at a specialized orthopedic surgery institute.
  • Fifty-eight patients requiring revision or complex TKR received a Guepar II prosthesis.

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  • Follow-up ranged from 2 to 13 years, with outcomes assessed via radiolucency and clinical scoring.

    • Main Results:

    • Aseptic loosening occurred in 7% of patients.
    • Radiolucency was observed in cemented and non-cemented components, primarily in specific zones.
    • Clinical outcomes were varied, with 42% of patients rated as poor.

    Conclusions:

    • Aseptic loosening is not a primary issue in hinge TKR.
    • High complication rates persist in patients requiring hinge prostheses.
    • Specific indications include severe instability, absent collateral ligaments, and extensor mechanism deficiency.