title: [ANALYSIS OF IMPLANT-RELATED COMPLICATIONS AFTER HINGE KNEE REPLACEMENT FOR TUMORS AROUND THE KNEE].
abstract: OBJECTIVE
  To investigate the reasons and managements of implant-related complications after hinge knee replacement for tumors around the knee.
  
  
  METHODS
  A retrospective analysis was made on the clinical data of 96 patients undergoing hinge knee replacement between January 2000 and December 2012. There were 64 males and 32 females with the mean age of 31.0 years (range, 15-72 years). The most common tumor type was osteosarcoma (72 cases), and the second was giant cell tumor (15 cases). The tumor located at the distal femurs in 52 cases and at the proximal tibias in 44 cases. Fifteen hinge and 81 rotating hinge prostheses were used. The recurrence, metastasis, and survival were recorded. The implant-related complications were observed.
  
  
  RESULTS
  The median follow-up time was 43.5 months (range, 10-156 months). Complications were observed in 21 patients (25 implant-related complications); 13 complications located at the femur and 12 complications at the tibia. The complications included aseptic loosening (8 cases), deep infection (7 cases), prosthetic breakage (4 cases), peri-prosthetic fracture (2 cases), and dislocation (4 cases). Most deep infection occurred within 12 months after operation (6/7), and most aseptic loosening after 40 months of operation (6/8). The rate of limb salvage was 90.6% (87/96) and the amputation rate was 9.4% (9/96). The overall survival rate of the prosthesis was 76.7% (5-year) and 47.2% (10-year). The 5-year survival rate was 82.9% for femoral prosthesis and 71.0% for tibial prosthesis, showing no significant difference (P = 0.954).
  
  
  CONCLUSIONS
  Hinge knee prosthesis still has a high rate of complications. Deep infection is main reason to decrease short-term prosthetic survival rate, and aseptic loosening shortens the long-short prosthetic survival time.
authors.forename: Dong
authors.initials: D
authors.lastname: Li
authors.forename: Huanzhi
authors.initials: H
authors.lastname: Ma
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Chengliang
authors.initials: C
authors.lastname: Sun
authors.forename: Xiaoyong
authors.initials: X
authors.lastname: Lu
authors.forename: Yutong
authors.initials: Y
authors.lastname: Gao
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D019645:Arthroplasty, Replacement, Knee; D001859:Bone Neoplasms / Q000601:surgery*; D005260:Female; D005269:Femur; D005870:Giant Cell Tumors / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000473:pathology* / Q000601:surgery; D007720:Knee Prosthesis / Q000009:adverse effects*; D023821:Limb Salvage; D008297:Male; D009364:Neoplasm Recurrence, Local; D012516:Osteosarcoma / Q000601:surgery*; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome