Current concepts in total knee arthroplasty: Rotating hinge prostheses

Open Access

Review

Table 1

Shows the main data and results from the included studies in this narrative review.

Study title, Authors, Journal, Year published	Number of patients + follow-up	Indications	Functional outcomes (pre-op mean compared with post op)	Implant survivorship	Complications
The use of a modular rotating hinge component in salvage revision total knee arthroplasty	16 revision knees	‐ Aseptic loosening (8) ‐ Loosening and bone loss associated with chronic extensor mechanism disruption (2) ‐ Component instability (3) ‐ Fracture (1)	‐ KSCS 41–131 ‐ ROM 78°–93°	N/A	‐ Intraoperative fracture (1) ‐ Patella subluxation requiring revision (1) ‐ Mechanical failure of implant (1) ‐ Partial peroneal palsy (1)
Robert L. Barrack, MD, Thomas R. Lyons, MD, Robert Q. Ingraham, MD, Jeremy C. Johnson, MD	Mean follow-up of 51 months (2–6 years)
The Journal of Arthroplasty
2000
Salvage revision total knee replacement using the Endo-Model® rotating hinge prosthesis	51 revision cases	‐ Infection (23) ‐ Aseptic loosening (23) ‐ Implant failure (3) ‐ Stiffness (1) ‐ Peri-prosthetic fracture (1)	‐ HSS 35.9–72.17 ‐ ROM 89.9° at one year f/u	N/A	‐ Amputation (2)
N.R. Pradhan, L. Bale, P. Kay, M.L. Porter	Mean follow-up of 4 years (range 2–6 years)
The Knee
2004
Rotating hinged total knee replacement: Use with caution	44 patients	‐ Massive bone loss secondary to failed arthroplasty (27) ‐ Instability (10) ‐ Periprosthetic fracture (4) ‐ Comminuted distal femoral fracture (3)	‐ KSCS 28.9–73.5 ‐ KSFS 40–43 ‐ SF-36 physical: 28.3–41.1 ‐ SF-36 mental: 54.5–59.4	79.6% at one year and 68.2% at five years	Revisions ‐ Aseptic loosening (4) ‐ PJI (2) ‐ Periprosthetic fracture (1)Reoperations total ‐ Haematoma (8) ‐ PJI (3) ‐ Excision of retained cement (1)
Aidin Eslam Pour¹, Javad Parvizi, Nicholas Slenker, James J Purtill, Peter F Sharkey	Minimum 2 year follow-up
Bone and Joint Journal
2007
Complications following rotating hinge Endo-Modell (Link ^® ) knee arthroplasty	Primary (52)	Primary ‐ OA with ligament laxity or significant malalignment (37) ‐ Tumour (1) ‐ Post traumatic arthritis (8) ‐ Rheumatoid arthritis (6)Revision ‐ Infection (9) ‐ Aseptic loosening (24)	NA	89.4% at three years	‐ Cement shock leading to death (1) ‐ PJI requiring joint lavage (2) ‐ CPN lesions partially resolving (2) ‐ Acute ischaemia requiring arterial surgery (1) ‐ PJI requiring revision components (2) ‐ PJI requiring arthrodesis (2) ‐ PJI treated with DAIR (3) ‐ Aseptic loosening (3) ‐ Patella complications (4)
B. Guenoun ^a, L. Latargez ^a, M. Freslon ^a, G. Defossez ^b, N. Salas ^a, L.-E. Gayet	Revision (33)
Orthopaedics & Traumatology: Surgery & Research	Mean follow-up 36 months
2009	Mean follow-up 36 months
*Mid-term results after implantation of rotating-hinge knee prostheses: Primary versus* revision**	21 primary	Primary: ‐ Severe bone loss ‐ Ligamentous instability ‐ Malalignment ‐ Fracture ‐ Ankylosis ‐ InfectionRevision ‐ Infection ‐ Aseptic loosening ‐ Instability ‐ Periprosthetic fractures ‐ Malimplantation ‐ Poor ROM ‐ Progressive arthrosis	Primary ‐ KSCS 82 ‐ KSFS 58 ‐ ROM 88Revision ‐ KSCS 80 ‐ KSFS 47 ‐ ROM 89	Survival rates at final follow-up ‐ Primary 95% ‐ Revision 76%	Primary ‐ Recurrent dislocation (1) ‐ Periprosthetic Fracture (1) ‐ Infection (1)Revision ‐ Infection (8) ‐ Aseptic loosening (2) ‐ Inlay breakage (1) ‐ Periprosthetic fracture (1) ‐ Chronic pain (1) ‐ Septic loosening (1) ‐ Recurrent dislocation (1)
Turgay Efe¹, Philip P Roessler¹, Thomas J Heyse¹, Carsten Hauk², Caroline Pahrmann³, Alan Getgood⁴, Jan Schmitt	28 revision
Orthopaedic Reviews	Mean follow-up 56 months
2012	Mean follow-up 56 months
Rotating-hinge total knee for revision total knee arthroplasty	31 Revisions	‐ Aseptic loosening (23) ‐ Septic loosening (4) ‐ Instability (3) ‐ Wear (1)	‐ HSS score 65.5–88.4 ‐ ROM 90.9–114.4	N/A	‐ Revisions for progressive radiolucent lines (2) ‐ Complications (10)
Alessandro Bistolfi¹, Giuseppe Massazza, Federica Rosso, Maurizio Crova	Average follow-up 60.3 months (range, 32–100 months)
Orthopaedics
2012
Constraint choice in revision knee arthroplasty	67 revisions to:PS knee (7)CCK (35)RHK (18)	‐ Ligament absence/disruption ‐ Type 2 or 3 AORI bone loss	Combined median results of all 3 implants ‐ IKS clinical score 41 to 81 ‐ IKS function score 21.5 to 79 ‐ HSS score 34 to 83.5 ‐ ROM 74 to 121	N/A	Hinged knee rerevisions total ‐ Persistent pain (1) ‐ Aseptic loosening (1)
Michele Vasso^1,✉, Philippe Beaufils², Alfredo Schiavone Panni¹	Median follow-up 9 years (range, 4–12).
International Orthopaedics
2013
Revision knee arthroplasty for bone loss: Choosing the right degree of constraint	94 revisions	Bone defect with AORI grade II or III bone loss	AORI II revision for infection increase of mean score: ‐ KSS by 47.2 ‐ KSFS by 53.3 ‐ Modified KSS by 31.6AORI III septic revision increase in mean score: ‐ KSCS by 28.7 ‐ KSFS by 11.5 ‐ Modified KSS by 23.1	NA	AORI II infections: ‐ Aseptic revisions (4) ‐ Septic revisions there were (3)AORI III infections: ‐ Aseptic (6) ‐ Septic (8)Other: ‐ Extensor mechanism failure (2) ‐ Aseptic loosening (1)
Chao Shen, MD, Paul M. Lichstein, MD, MS, Matthew S. Austin, MD, Peter F. Sharkey, MD, Javad Parvizi, MD, FRCS
The Journal of Arthroplasty
2013
Mid-term survival following primary hinged total knee replacement is good irrespective of the indication for surgery	964 primary cases	‐ OA (686) ‐ Inflammatory arthropathy (95) ‐ Post-traumatic arthritis (81)	N/A	5 year survival rate of 96.8%	Revision (20) ‐ Infection (8) ‐ Peri-prosthetic fracture (4) ‐ Aseptic loosening (3) ‐ Dislocation (1) ‐ Pain (1) ‐ Malalignment (2) ‐ Other (1)
Paul Baker¹, Rebecca Critchley, Andrew Gray, Simon Jameson, Paul Gregg, Andrew Port, David Deehan	964 primary cases		N/A	5 year survival rate of 96.8%
Intermediate-term results of 142 single-design, rotating-hinge implants: Frequent complications may not preclude salvage of severely affected knees	Primary (11)	‐ PJI (60) ‐ Severe arthrofibrosis requiring collateral ligament release and femoral shortening (16) ‐ Aseptic loosening (17) ‐ Instability (15) ‐ Symptomatic knee fusion requiring rotating hinge reconstruction (7) ‐ OA (11) ‐ Periprosthetic fracture (7) ‐ Mechanical failure (5) ‐ Non-union of distal femur fracture (2)	‐ KSCS 36 to 77 at the ‐ KSFS 21 to 57	Implant survival was 73%	Failed implants (39) ‐ Aseptic femoral loosening (18) ‐ Aseptic tibial loosening (1) ‐ Aseptic femoral and tibial loosening (1) ‐ Periprosthetic fracture (7) ‐ Infection (12)
Yasser R. Farid, MD, PhD^a, Rishi Thakral, MD, FRCSI^b, Henry A. Finn, MD, FACS	Revision (131)
The Journal of Arthroplasty	57 months follow-up
2015	57 months follow-up
Revision total knee arthroplasty for instability-outcome for different types of instability and implants	19 revisions	‐ Instability	‐ KSFS 40 to 50 ‐ KSCS 18 to 68.5 ‐ ROM remained at 110	N/A	‐ Pain around the knee (7) ‐ No reoperations
Jaap S Luttjeboer¹, Menno R Bénard², Koen C Defoort³, Gijs G van Hellemondt³, Ate B Wymenga³	Followed up to 24 months postoperatively
Journal of Arthroplasty
2016
Long-term results after total knee arthroplasty with contemporary rotating-hinge prostheses	Complex primary (74)	‐ Infection (144) ‐ Aseptic etiologies (264)	‐ KSCS improved 51 to 81 ‐ KSFS 26 to 36	Cumulative incidence of revision for any revision was 9.7% at 2 years and 22.5% at 10 years	Revisions ‐ PJI (21) ‐ Periprosthetic fracture (11) ‐ Aseptic loosening (10) ‐ Mechanical failure (10) ‐ Extensor mechanism disruption (4) ‐ Arthrofibrosis (2) ‐ Chronic patellar dislocation (1)Reoperations ‐ PJI (24) ‐ Dissociation of the prosthetic hinge (1)Intraoperative complications ‐ Fracture (20) ‐ Periprosthetic tibial fracture (9) ‐ Partial patellar tendon avulsion (2)Postoperative complications ‐ Delayed wound-healing (12) ‐ Decreased range of motion (10) ‐ Superficial wound infections (5) ‐ Periprosthetic fracture (6) ‐ Patella instability (4) ‐ Skin necrosis (3) ‐ Partial quadriceps tears (2) ‐ DVT (1) ‐ Peroneal nerve palsy (1)
Umberto Cottino¹, Matthew P Abdel, Kevin I Perry, Kristin C Mara, David G Lewallen, Arlen D Hanssen	Revision (334)
The Journal of Bone and Joint Surgery	Mean follow-up 4 years (range, 2 to 12 years)
2017	Mean follow-up 4 years (range, 2 to 12 years)
Rotating hinge implants for complex primary and revision total knee arthroplasty	Complex primary (14)	Primary: ‐ Severe deformity (7) ‐ Recurvatum (6) ‐ Charcot arthropathy (1)Revision: ‐ Severe instability (28) ‐ Periprosthetic joint infection (15) ‐ Dislocation (12) ‐ Aseptic loosening (7) ‐ Periprosthetic fracture (3)	‐ KSCS 35.7 to 66.2	70.7% at 5 years	Intraoperative ‐ Fracture (1)Postoperative ‐ Periprosthetic fracture (6) ‐ Extensor mechanism rupture (5) ‐ PJI (4) ‐ Mechanical failure of hinge (3) ‐ Arthrofibrosis (2) ‐ Peroneal nerve palsy (1) ‐ Recurvatum (1) ‐ Aseptic loosening (1) ‐ Superficial abscess (1)
Sean M Kearns¹, Brian M Culp¹, Daniel D Bohl¹, Scott M Sporer¹, Craig J Della Valle¹, Brett R Levine¹	Revision (65)
The Journal of Arthroplasty	Minimum 2 year follow-up, mean 55.2 months
2018	Minimum 2 year follow-up, mean 55.2 months
Rotating-hinge knee prosthesis as a viable option in primary surgery: Literature review & meta-analysis	Primary non tumour cases (1425)	Primary non-tumour cases: ‐ Osteoarthritis ‐ Rheumatoid arthritis ‐ Post traumatic arthritis ‐ Supracondylar malunion ‐ Charcot arthropathy	Non-tumour: ‐ KSCS 84.9 ‐ KSFS 67.9Tumour cases: ‐ MSTS mean 79%	Primary non-tumour: overall survival rates for 0–5, 6–10, and 11–15 year follow-up were 92%, 82%, and 88% respectivelyPrimary tumour cases: overall survival rates for 0–5 and 6–10 year follow-up were 77% and 69% respectively	Causes of failure in primary non-tumour ‐ Infection (23) ‐ Aseptic loosening (13) ‐ Dislocation (13) ‐ Periprosthetic fracture (8) ‐ Rotation failure (5) ‐ Other (11)Causes of failure in primary tumour ‐ Infection (65) ‐ Aseptic loosening (41) ‐ Tumour recurrence (40) ‐ Fracture (26) ‐ Dislocation (1)
Ali Abdulkarim¹, Anna Keane², Shu Yang Hu², Lachlan Glen², Dermot J Murphy³	Primary tumour (936)
Orthopaedics & Traumatology: Surgery & Research
2019
Primary constrained and hinged total knee arthroplasty: 2and 5-year revision risk compared with unconstrained total knee arthroplasty: A report on 401 cases from the Norwegian Arthroplasty Register 1994–2017	197 RHTKA cases	‐ Primary OA (64) ‐ Inflammatory arthritis (15) ‐ Post-traumatic arthritis (28) ‐ Postligament injury (37) ‐ Post infection arthritis (9) ‐ Instability (13) ‐ Neuro sequelae (10) ‐ Other (20)	N/A	2- and 5-year survival free of all revisions for primary hinged TKA was 91.0%	22 revisions ‐ Infection (16)7 perioperative complications ‐ Fracture (4)
Mona Badawy¹, Anne Marie Fenstad², Ove Furnes	Maximum 20 year follow-up
Acta Orthopaedica
2019
Survivorship of highly constrained prostheses in primary and revision total knee arthroplasty: Analysis of 6070 cases	1033 primary	N/A	N/A	Primary: CPR of 15.9% at 11 yearsRevision: CPR at 9 years 17.5%	Primary ‐ Infection (27) ‐ Loosening (10) ‐ Fracture (14) ‐ Instability (1) ‐ Patellofemoral pain (5) ‐ Bearing dislocation (3) ‐ Patella erosion (3) ‐ Pain (3) ‐ Other (9)Revision ‐ Infection (32) ‐ Loosening (15) ‐ Instability (2) ‐ Pain (3) ‐ Arthrofibrosis (1) ‐ Fracture (8) ‐ Patellofemoral pain (3) ‐ Implant breakage (6) ‐ Other (7)
Matthew Knight¹, Peter Lewis¹, Yi Peng¹, Alesha B Hatton¹, Ben Parkinson	807 revisions
ANZ Journal of Surgery	Mean follow-up 3.9 years for primary, 3.4 years for revision
2020
Increased constraint of rotating hinge knee prosthesis is associated with poorer clinical outcomes as compared to constrained condylar knee prosthesis in total knee arthroplasty	Primary (8)	‐ Global instability and recurvatum during primary TKA (8) ‐ Failed TKA with extensive bone loss, osteolysis and instability (17) ‐ Periprosthetic fracture (4) ‐ PJI, instability and extensive bone loss (10)	‐ ROM improvement 90.4 to 103.2 ‐ KSFS 30.7 to 43.9 ‐ KSCS 28.5 to 76.5 ‐ OKS 42.7 to 27.9	NA	‐ I + D for superficial abscess (3) ‐ PJI managed with 2 stage revision (5) ‐ Extensor mechanism defect requiring reoperation (1)
Jason Beng Teck Lim¹², Hee Nee Pang³, Keng Jin Darren Tay³, Shi-Lu Chia³, Ngai Nung Lo³, Seng Jin Yeo	Revision (31)
European Journal of Orthopaedic Surgery & Traumatology	Mean follow-up 4.8 years (range 2–9.2 years)
2020	Mean follow-up 4.8 years (range 2–9.2 years)
Guided-motion hinged knee replacement prosthesis: Early survival rate and postoperative patient function and satisfaction	12 primary	Primary: ‐ MCL incompetence (12)Revision cases ‐ Instability (17) ‐ Infection (4) ‐ Aseptic loosening (4) ‐ Combined instability and aseptic loosening (2)	Oxford-12 Knee Score 12.9 to 27.8 at 2 year follow-up	2-year survivorship of 90.7%	Reoperations for failure of components ‐ Patella dislocation/subluxation (2) ‐ Infection (1)Reoperations with no components revised ‐ Medial capsule repair (1) ‐ Extensor mechanism repair (2) ‐ Periprosthetic fracture (1)
David L Perrin¹, Thomas R Turgeon¹	27 revision
Canadian Journal of Surgery	Mean follow-up of 29.1 months
2020	Mean follow-up of 29.1 months
Periprosthetic knee infection reconstruction with a hinged prosthesis: Implant survival and risk factors for treatment failure	39 revisions	Primary TKA PJI along with the Anderson Orthopaedic Research Institute (AORI) classification type II or III bone and ligament deficiency	‐ KSCS 37.9 points to 70.7 ‐ KSFS 25.7 to 56.5	Survivorship of 86.2% at 2 years and 70.2% at 5 years.	‐ Recurrent PJI (9) ‐ Aseptic loosening (1)
Michael Jian-Wen Chen^a, Jui-Fu Hung^b, Chih-Hsiang Chang^a,b, Sheng-Hsun Lee^a,b, Hsin-Nung Shih^a,b, Yu-Han Chang	Mean follow-up of months 64
The Knee
2020
Management of gonarthrosis with a rotating hinge prosthesis: Minimum 10-year follow-up	Primary (238)	‐ Advanced deformity (150) ‐ Significant bone loss (48) ‐ Ligamentous laxity (40)	‐ Mean flexion at final review 118°	Overall survivorship at a mean of 13.5 years of follow-up was 88%	19 revisions with prosthesis exchange ‐ Patella resurfacing (6) ‐ PJI (5) ‐ Mechanical failure (5) ‐ Aseptic loosening (1) ‐ Extensor mechanism disruption (1) ‐ Periprosthetic fracture (1)9 reoperations with no revision of components ‐ Patella debridement (3) ‐ Lateral release _ medial plication (2) ‐ Excision of inferior pole of patella (2) ‐ Open arthrolysis (1) ‐ Fixation of distal femur fracture (1)
Daniel Kendoff^, Carl Haasper^, Thorsten Gehrke^, Wolfgang Klauser^, Nemandra Sandiford^*	At final review (160)
Clinics in Orthopaedic Surgery	Minimum of 10 year follow-up, mean of 13.5 years
2020	Minimum of 10 year follow-up, mean of 13.5 years
Complications and failures of non-tumoral hinged total knee arthroplasty in primary and aseptic revision surgery: A review of 290 cases	290 cases	Primary surgery (111) ‐ Large deformity (61) ‐ Arthropathy (29) ‐ Ligament laxity (11) ‐ Primary OA (10)Aseptic revision surgery (127 patients) ‐ Loosening (75) ‐ Ligament laxity (50) ‐ Other (2)Surgery following a recent (< 3 months) fracture (52) ‐ Post traumatic sequelae (25) ‐ Fracture in an older adult (17) ‐ Non-union (8) ‐ Laxity (2)	N/A	N/A	Complications (108) ‐ Stiffness (41) ‐ Pain (37) ‐ Infection (32) ‐ Loosening (23) ‐ Extensor mechanism instability/rupture (19) ‐ Periprosthetic fracture (9) ‐ Common peroneal nerve deficit (2) ‐ Mechanical failure (2) ‐ Death(40)Revisions for Infection (31) ‐ Implant changes (12) ‐ Above knee amputation (4) ‐ Arthrodesis (2)Revisions for aseptic loosening (17)Revision for periprosthetic fracture or mechanical implant failure (11)Revisions for patellofemoral instability (2)Reoperations ‐ Arthrolysis (2) ‐ Lavage of joint for infection (13) ‐ Extensor mechanism rupture (4)
Étienne Caron¹, Antoine Gabrion², Matthieu Ehlinger³, Nicolas Verdier⁴, Brice Rubens-Duval⁵, Thomas Neri⁶, Pierre Martz⁷, Sophie Putman⁸, Gilles Pasquier⁸	Minimum follow-up of 5 years
French Society of Orthopedic Surgery and Traumatology (SOFCOT)	Mean follow-up 71 months
2021	Mean follow-up 71 months
Constraint in complex primary total knee arthroplasty: Rotating hinge versus condylar constrained implants	703 primary complex non-oncological cases	NA	NA	10-year implant survival rates of 91.9%	PJI was the most common reason for revision in the two cohorts, followed by aseptic loosening.Breakage in 3 cases
Francesco Castagnini¹², Barbara Bordini³, Monica Cosentino³, Cristina Ancarani³, Stefano Lucchini⁴, Giovanni Bracci⁴, Francesco Traina	Mean follow-up 6.8 years
Archives of Orthopaedic and Trauma Surgery
2022
Shortto midterm outcomes of a novel guided-motion rotational hinged total knee arthroplasty	18 complex primaries	NA	Improved ROM on average 9 degrees	Survivorship analysis for implant revision at 2and 5-year follow-up showed a survival rate of 100% and 98.5%	Aseptic reoperations (14) ‐ Patellar Complications (7) ‐ Instability: (5) ‐ Tuberosity Fixation Issues: (1) ‐ Extensor Mechanism Failure (1)Infections (15)Implant revisions (2) ‐ Infection (1) ‐ Aseptic loosening (1)
David Yeroushalmi¹, Simon Van Laarhoven², Alex Tang¹, Petra J C Heesterbeek², Gijs Van Hellemondt², Ran Schwarzkopf	129 revisions identified
Journal of Knee Surgery	Average follow-up duration of 3.8 years (Minimum 2 years)
2022	Average follow-up duration of 3.8 years (Minimum 2 years)
Implant survivorship, functional outcomes and complications with the use of rotating hinge knee implants: A systematic review	568 primary	Primary ‐ Osteoarthritis ‐ Rheumatoid arthritisRevision ‐ Aseptic loosening ‐ Infection ‐ Instability ‐ Implant wear/breakage ‐ Bone loss ‐ Periprosthetic fracture	Post op ROM median was 110°KSCS 7.4 to 86.2KSFS 27.9 to 58.4OKS 11.6 to 31.5	Median survival at 1 year was 93.4% (two studies), at 5 years was 85.9% (one study) and at 10 years was 87% (three studies	NA
Joshua Xu^1,2,✉, Lennart von Fritsch², Shiraz A. Sabah², Andrew J. Price^1,2, Abtin Alvand^1,2	413 revision
Knee Surgery and Related Research	Median follow-up of 79.5 months
2022	Median follow-up of 79.5 months
Rotating hinge prosthesis for primary and revision knee arthroplasty: Comparison and indications	98 primary	Primary: ‐ Varus/valgus malalignment ‐ Instability ‐ Extension deficit ‐ Obesity ‐ Posttraumtic gonarthrosis ‐ Rheumatism ‐ Unconstrained knee cannot be balanced ‐ Bone loss ‐ OtherRevision ‐ Instability ‐ Aseptic loosening ‐ Periprosthetic fracture ‐ Arthrofibrosis ‐ Other	Primary: ‐ ROM 108.7 to 117.9 ‐ OKS: 24.4 to 8.5 ‐ KSFS 57.3 to 73.5 ‐ KSCS 35 to 89.5Revision: ‐ ROM 110.7 to 114.6 ‐ OKS 23.8 to 13.9 ‐ KSFS 56.7 to 67.8 ‐ KSCS 37.5 to 78.1	Primary: 91% at 5 yearsRevision: 70% at 5 years	Primary: ‐ Infection (7) ‐ Periprosthetic fracture (6) ‐ Aseptic loosening and instability (2)Revision: ‐ Infection (6) ‐ Aseptic loosening (6) ‐ Poor function (1)
Hans-Joachim Neuhaus, Kristin Maier	22 revision
Biochem Research International	5 year follow-up
2022	5 year follow-up
Acceptable migration of a fully cemented rotating hinge-type knee revision system measured in 20 patients with model-based RSA with a 2-year follow-up	17 revisions	N/A	‐ KSCS 52 to 65 ‐ KSFS functional 55 to 50 ‐ OKS total 21 to 31	100% survivability at 2 years follow-up	11 complicatons ‐ Recurrence of arthrofibrosis [4] ‐ Neuropathic pain [5] ‐ Deep venous thrombosis [1] ‐ Recurrence of quadriceps tendon rupture [1] ‐ Pneumonia [1] ‐ Extended wound leakage [1] ‐ 1 patient requiring reoperation (full allograft extensor mechanism reconstruction)
Simon N. van Laarhoven^1,✉, Malou E.M. Te Molder², Gijs G. Van Hellemondt¹, Petra J.C. Heesterbeek²	Follow-up 24 months
Acta Orthopaedica
2023
Condylar constrained and rotating hinged implants in revision knee arthroplasty show similar survivorship and clinical outcome: A systematic review and meta-analysis	1131 revisions	‐ Aseptic loosening (354) ‐ Instability (272) ‐ Infection (235) ‐ Malalignment (26) ‐ Fracture (54) ‐ Arthrofibrosis (76)	KSCS of 35.1 to 80.2KSFS of 30 to 58.5ROM 69.1 to 104.1°	Survivorship of 91.6% at 5 years	Revisions ‐ Aseptic loosening (246) ‐ Instability (7) ‐ PJI (33) ‐ Fracture (5) ‐ Extensor mechanism failure (1) ‐ Knee dislocation (4) ‐ Arthrodesis (2)Reoperations ‐ MUA (5) ‐ Extensor mechanism repair (11) ‐ DAIR (8) ‐ Fracture (8)
Lenka Stroobant¹, Thijmen de Taeye², Paul Byttebier³, Stefaan Van Onsem⁴, Ewoud Jacobs⁵, Arne Burssens², Jan Victor²	Mean follow-up 83.2 months
Knee Surgery Sports Traumatology Arthroscopy
2023
Risk factors for revision surgery following revision total knee arthroplasty using a hinged knee prosthesis for septic and aseptic indications	150 revisions	‐ Infection (85) ‐ Aseptic revision (65)	NA	Survivorship for all-cause revision surgery in the aseptic cohort was 86.2% at 1 year, 81.5% at 2 years, and 71.4% at 5 yearssurvivorship for revision surgery in the septic cohort was 90.6% at 1 year, 76.5% at 2 years, and 46.1% at 5 years	Re-revision in septic cases (40) ‐ Persistent infection (22) ‐ Mechanical loosening (7) ‐ Extensor mechanism rupture (5) ‐ Periprosthetic fracture (3) ‐ Wound complications (1) ‐ Haematoma (2)Re revision in aseptic cases (16) ‐ Persistent infection (4) ‐ Mechanical loosening (3) ‐ Instability (1) ‐ Extensor mechanism rupture (2) ‐ Periprosthetic fracture (1) ‐ Wound complications (1) ‐ Haematoma (1) ‐ Non union (1) ‐ Persistent knee pain (1)
Cody C. Green¹, John W. Stelzer, Matthew S. Kerr, Alex Tang, Luke G. Menken, Filippo Romanelli, Justin M. Miller, Frank A. Liporace, George J. Haidukewych, Richard S. Yoon	Minimum follow-up of 2 years
Journal of the American Academy of Orthopaedic Surgeons	Average follow-up 4.9 in the septic cohort vs. 4.6 years in the aseptic cohort
2023
Clinical outcomes and infection rates following revision total knee arthroplasty: Aseptic failure versus septic failure	68 revisions for aseptic failure	Aseptic ‐ 57 patients underwent surgery due to aseptic loosening ‐ 9 due to instability ‐ 2 due to stiffness	Functional scores of all cases ‐ ROM 110 to 120 ‐ WOMAC 49.9 to 9.6 ‐ KSKS 49.4 to 86.1 ‐ KSFS 40.8 to 69	NA	Aseptic group complications ‐ Infection (3) ‐ Polyethylene change due to instability (1)Septic group complications ‐ Infection (4)
Sung-Sahn Lee¹, Il Su Kim², Young-Wan Moon²	26 revisions for septic failure
Clinics in Orthopaedic Surgery	Mean follow-up durations in the aseptic and septic groups were 44.4 and 54.8 months, respectively.
2023

Current usage metrics show cumulative count of Article Views (full-text article views including HTML views, PDF and ePub downloads, according to the available data) and Abstracts Views on Vision4Press platform.

Data correspond to usage on the plateform after 2015. The current usage metrics is available 48-96 hours after online publication and is updated daily on week days.

Initial download of the metrics may take a while.