title: Is there a future for hinged prostheses in primary total knee arthroplasty? A 20-year survivorship analysis of the Blauth prosthesis.
abstract: The Blauth prosthesis is a hinged total knee replacement. We have evaluated 422 consecutive primary total knee arthroplasties using this design in 330 patients with a maximum follow-up of 20 years (mean 6). The mean age of the patients at the time of operation was 70 years (29 to 87). Using endpoints of infection, removal because of aseptic loosening, removal for any cause, and the worst case as definitions of failure, the cumulative rates of survival at 20 years were 93.6%, 96.0%, 94.4% and 86.8%, respectively. The cumulative rate of survival of the patients themselves was 14.4% (24% in patients with osteoarthritis and 9% in these with rheumatoid arthritis) after 20 years. Our survivorship analysis shows that hinged knee prostheses, when they are biomechanically well designed, can yield a satisfactory long-term outcome, similar to those of the best prostheses of the resurfacing type. Hinged knee prostheses continue to be of value in patients with severe deformity or instability of the knee.
authors.affiliation: Orthopädische Universitätsklinik, Eberhard-Karls-Universität, Tübingen, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Böhm
authors.forename: T
authors.initials: T
authors.lastname: Holy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D001696:Biomechanical Phenomena; D016001:Confidence Intervals; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D050723:Fractures, Bone / Q000209:etiology; D006801:Humans; D016916:Joint Deformities, Acquired / Q000601:surgery; D004204:Joint Dislocations / Q000209:etiology; D007593:Joint Instability / Q000601:surgery; D007720:Knee Prosthesis / Q000009:adverse effects; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D010329:Patella / Q000293:injuries; D011183:Postoperative Complications; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology; D012086:Reoperation; D016019:Survival Analysis; D015996:Survival Rate; D017211:Treatment Failure; D016896:Treatment Outcome