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The use of rotating hinge design for revision
arthroplasty should be recommended in the selected cases as it allows much more
aggressive capsuloligament debridement.
According to the research conducted by the University Hospitals Leuven and Hospital Genk, revision arthroplasty of the stiff knee using a rotating hinged device shows significant outcomes to manage knee osteoarthritis. To treat end-stage knee osteoarthritis, total knee arthroplasty (TKA) endures the gold standard. But, stiffness occurred following the therapy at the rate of 1.3% to 5.3%. The issue can be solved using the revision TKA.
However, revised TKA found to be less favourable for idiopathic arthrofibrosis and stiffening, which can be due to the use of conventional PS or CCK-type revision implants. Therefore, by using a rotating hinge design (RHK) instead of traditional options, better outcomes can be attained, because RHK designs lead to adequate fibrosis removal as it provides more adequate fibrosis removal, while achieving optimal implant stability, flexion-extension space stability, and tibiofemoral rotational freedom. The present study was conducted to evaluate whether a rotating hinge design (RHK) is effective than CCK revision arthroplasty for the stiff total knee arthroplasty.
A total of 40
individuals with a defined range of knee motion selected and individuals with
component malposition, underlying mechanical malalignment, infections, and
soft-tissue imbalance were excluded. Out of 40 patients, 22 obtained a
hinged-type prosthetic device, and 18 got a less constrained condylar type
prosthetic device. With RHK, similar preoperative data as CCK-type implants was
noticed except for knee pain score, which was considerably worse for the RHK
group. The RHK group showed significantly better postoperative outcomes for
greater extension gain, knee pain improvement, greater maximal flexion, better
maximal extension, greater flexion gain, knee function scores, and knee
function improvement as compared to CCK at two years of follow-up. The findings
explain that the revised TKA with a rotating hinged device presents a
significant impact on arthritis management.
The Knee
Hinged versus CCK revision arthroplasty for the stiff total knee.
K. Hermans et al.
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