title: Comparison of mechanical and nonmechanical failure rates associated with rotating hinged total knee arthroplasty in nontumor patients.
abstract: Rotating hinge total knee arthroplasty (TKA) has had acceptable to poor results in terms of clinical outcomes and survivorship, leading to skepticism with regard to its use. A total of 271 hinged TKAs performed between 1998 and 2008 were studied to determine survivorship and factors affecting survivorship. A median survivorship of 6.9 years was found for the best-case cohort (n = 111), and 4.1 years, for the worst-case group (n = 174). Of the 111 patients, 51 (45.9%) experienced a failure that required reoperation, with more than half of these (29/51, or 56.9%) due to nonmechanical modes of failure. Comparison of the kinematic hinge implants with the distal femoral replacements showed that the Kaplan-Meier survivorship was slightly higher for the patients with distal femoral replacements, although this was not significant (P = .962). Our study suggests that the hinge TKA is well designed and provides acceptable survivorship in healthy patients who do not have nonmechanical complications.
authors.affiliation: Cleveland Clinic Foundation, Department of Orthopaedic Surgery, Orthopaedics and Rheumatology Institute, Cleveland, OH 44195, USA.
authors.forename: Travis H
authors.initials: TH
authors.lastname: Smith
authors.forename: Bishoy V
authors.initials: BV
authors.lastname: Gad
authors.forename: Alison K
authors.initials: AK
authors.lastname: Klika
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Styron
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Joyce
authors.forename: Wael K
authors.initials: WK
authors.lastname: Barsoum
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007719:Knee Joint / Q000000981:diagnostic imaging; D007720:Knee Prosthesis; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000209:etiology*; D011859:Radiography; D012086:Reoperation