title: The modular segmental kinematic rotating hinge for nonneoplastic limb salvage.
abstract: From January 1980 to July 1998, 25 patients (26 knees) were treated with an arthroplasty using a Modular Segmental Kinematic Rotating Hinge total knee prosthesis for nonneoplastic limb salvage. The indications included: nonunion of a periprosthetic femur fracture (11 knees), severe bone loss and ligamentous instability (eight knees), nonunion of a supracondylar femur fracture (four knees), acute periprosthetic fracture (one knee), fracture of a previous hinge (one knee), and prior resection arthroplasty (one knee). The average age of the patients was 72.3 years. Twenty-two arthroplasties were revisions. The average followup was 58.5 months. At the latest followup, knee extension averaged 2.4 degrees and flexion averaged 93.6 degrees. The Knee Society knee score improved from an average of 45.4 preoperatively to 75.5. Preoperatively, functional scores averaged 8.6 and improved to 25. Complications occurred in eight patients. The most common was deep infection (five patients). The use of the Modular Kinematic Rotating Hinge for nonneoplastic limb salvage represents a small proportion (0.14%) of all primary and revision knee arthroplasties done at our institution. The indications for the surgery are for a highly complex and small subset of patients. The patients in the current study gained significant improvement in overall range of motion, Knee Society knee scores, and functional scores when this prosthesis was used.
authors.affiliation: Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Bryan D
authors.initials: BD
authors.lastname: Springer
authors.forename: Franklin H
authors.initials: FH
authors.lastname: Sim
authors.forename: Arlen D
authors.initials: AD
authors.lastname: Hanssen
authors.forename: David G
authors.initials: DG
authors.lastname: Lewallen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007720:Knee Prosthesis / Q000009:adverse effects; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome