Knee arthroplasty with rotating-hinge implant: an option for complex primary cases and revisions

Helito, Camilo Partezani; Giglio, Pedro Nogueira; Cavalheiro, Camila Maftoum; Gobbi, Riccardo Gomes; Demange, Marco Kawamura; Camanho, Gilberto Luis

doi:10.1016/j.rboe.2017.01.010

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Sumário

Artigos Originais • Rev. bras. ortop. 53 (2) • Mar-Apr 2018 • https://doi.org/10.1016/j.rboe.2017.01.010 copy

Knee arthroplasty with rotating-hinge implant: an option for complex primary cases and revisions^☆ ☆ Study conducted at the Universidade de São Paulo, Faculdade de Medicina, Hospital das Clinicas, Instituto de Ortopedia e Traumatologia, Divisão de Cirurgia de Joelho, São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To present the indications, technical aspects, and initial results of the first cases using Endo-Model™ implants in Brazil.

Methods:

A prospective study was conducted. It included nine patients submitted to a total knee arthroplasty, of which six were primary and three were revisions, using exclusively the Endo-Model™ implant. These patients were followed for an average of 12 months and evaluated with functional scores, such as the Knee injury and Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS), and visual analog pain scale (VAS).

Results:

There were statistically significant improvements in all scores evaluated in every patient. Only one complication occurred postoperatively (apraxia of the peroneal nerve) and did not require surgery revision.

Conclusion:

The use of a rotating-hinge implant for knee arthroplasty is a new option for complex cases with severe instability in Brazil; the initial results are satisfactory.

Keywords:
Knee arthroplasty; Knee joint; Range of articular motion; Joint instability; Knee prosthesis

Patients	Age	Gender	Comorbidities	Indication
1	69	F	Hypertension Dyslipidemia	Varus 20º
2	55	F	Rheumatoid arthritis	TKA revision after infection
3	72	F	Hypertension Dyslipidemia	TKA revision after infection
4	60	M	Hypertension Gouty arthritis	Varus 30º
5	68	M	No comorbidities	Varus 25º
6	55	F	Hypertension	Valgus 20º
7	79	F	Hypertension Cardiac arrhythmia	Valgus 40º
8	65	F	Hypertension	Recurvatum 20º
9	83	F	Hypertension Coronary disease Obesity	TKA revision after infection

Patients	1		2		3		4		5		6		7		8		9
	Pre	Post	Pre	Post	Pre	Post	Pre	Post	Pre	Post	Pre	Post	Pre	Post	Pre	Post	Pre	Post
KOOS
Pain	32.2	94.4	27.8	80.6	30.6	80.6	44.4	77.8	43	91.7	36.1	77.8	33.3	91.7	41.7	82.1	22.2	97.2
Symptoms	25	92.9	28.6	72.1	21.5	71.4	32.1	82.4	42.9	92.8	28.6	82.1	32.1	92.9	35.7	91.7	39.3	92.9
DLA	41.2	92.5	35.3	81.2	25	44.1	39.71	57.4	27.9	77.9	42.7	73.5	29.4	89.7	41.2	77.9	30.9	83.8
Sports	0	40	0	85	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Quality	25	87.5	0	84	0	18.7	0	62.5	18.7	56.3	0	75	0	75.0	12.5	81.3	0	93.8
Total	28	86.3	25	88	22	51.2	29.8	61	25	72.0	25	72.1	31	61	32.7	72.6	23.8	79.2
KSS
Objective	38	94	50	100	45	81	19	88	30	94	26	65	15	97	25	94	8	95
Subjective	40	100	35	65	5	-10	20	20	10	40	35	65	20	85	35	70	-20	55
VAS	9	0	10	0	9	5	8	5	8	0	7	0	7	3	10	5	10	0

Patients	Preoperative	Postoperative	p-value
KOOS
Pain	35.4 (±6.25)	86.13 (±7.3)	<0.001
Symptoms	31.8 (±6.8)	85.7 (±9.1)	<0.001
DLA	34.8 (±6.7)	75.3 (±15.5)	<0.001
Sports	0	13.9 (±29.8)	0.181
Quality	6.3 (±9.9)	70.5 (±22.7)	<0.001
Total	26.9 (±3.7)	72.9 (±11.9)	<0.001
KSS
Objective	28.4 (±13.9)	89.8 (±10.8)	<0.001
Subjective	20.0 (±19.4)	54.4 (±33.6)	0.17
VAS	8.7 (±1.2)	2.0 (±2.5)	<0.001

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] *Corresponding author. E-mail: camilo_helito@yahoo.com.br (C.P. Helito).

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Knee arthroplasty with rotating-hinge implant: an option for complex primary cases and revisions☆ ☆ Study conducted at the Universidade de São Paulo, Faculdade de Medicina, Hospital das Clinicas, Instituto de Ortopedia e Traumatologia, Divisão de Cirurgia de Joelho, São Paulo, SP, Brazil.

ABSTRACT

Objective:

Methods:

Results:

Conclusion:

Knee arthroplasty with rotating-hinge implant: an option for complex primary cases and revisions^☆ ☆ Study conducted at the Universidade de São Paulo, Faculdade de Medicina, Hospital das Clinicas, Instituto de Ortopedia e Traumatologia, Divisão de Cirurgia de Joelho, São Paulo, SP, Brazil.