title: Intermediate-Term Results of 142 Single-Design, Rotating-Hinge Implants: Frequent Complications May Not Preclude Salvage of Severely Affected Knees.
abstract: Rotating-hinge knee prostheses have low survivorship and high complications except in primary arthroplasties in elderly patients. We retrospectively reviewed 142 single third-generation design, rotating hinge prostheses (11 primary procedures and 131 revisions) at 57 months follow up. Implant survival was 73%. Successful two-stage reimplantation for prosthetic infection was 78.4% but new infection rate was 22%. The tibial component was durable while the femoral component was problematic. We observed only one patellar maltracking and no polyethylene wear. A third generation rotating-hinge arthroplasty reconstruction was reliable in complex problems. Outcomes in primary situations were excellent. Complications were the rule rather than the exception in revisions. With timely intervention, attention to soft tissue coverage, and realistic expectations, complications were contained and functional benefits were appreciable.
authors.affiliation: Assistant professor, Clinical orthopedic surgery, University of Illinois at Chicago and Weiss Memorial Hospital Bone and Joint Replacement Center, Chicago, Illinois.
authors.forename: Yasser R
authors.initials: YR
authors.lastname: Farid
authors.affiliation: Fellow, University of Chicago and Weiss Memorial Hospital Bone and Joint Replacement Center, Chicago, Illinois.
authors.forename: Rishi
authors.initials: R
authors.lastname: Thakral
authors.affiliation: Professor of surgery, University of Chicago and Weiss Memorial Hospital Bone and Joint Replacement Center, Chicago, Illinois.
authors.forename: Henry A
authors.initials: HA
authors.lastname: Finn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D020959:Polyethylene; D020127:Recovery of Function; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies
chemical_list: D020959:Polyethylene
keywords: complications; knee arthroplasty; revision; rotating-hinge; salvage