Outcomes of rotating versus pure hinge knee arthroplasty in the setting of one-stage exchange for periprosthetic joint infection.

Liechti, Emanuel F; Linke, Philip; Gehrke, Thorsten; Citak, Mustafa; Lausmann, Christian (2024). Outcomes of rotating versus pure hinge knee arthroplasty in the setting of one-stage exchange for periprosthetic joint infection. International orthopaedics, 48(7), pp. 1751-1759. Springer 10.1007/s00264-024-06139-y

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PURPOSE

Rotating or pure hinge knee prostheses are often used in case of periprosthetic joint infection (PJI). Five-year survival data of rotating hinge implants ranging from 52 to 90%, whereas pure hinge data are sparse. This study describes the results of both hinge knee prostheses after one-stage septic exchange.

METHODS

One hundred sixty-seven one-stage septic exchanges of a primary unconstrained total knee arthroplasty (TKA) to a cemented hinge prosthesis (117 rotating and 50 pure hinge TKAs) performed between 2008 and 2017 were retrospectively reviewed. Exclusion criteria were stem extensions or augments used in primary TKA, history of extensor mechanism reconstruction, and a follow-up less than two years after surgery. Rates of reinfection, mechanical failures, and all-cause revision-free survival data were documented.

RESULTS

At five years, the all-cause revision-free survival was 77% (95% CI 69 to 82). Thirty-one patients (19%) had further revision for aseptic reasons. In the rotating hinge group, the mechanical failure rate was more than twice as high as in the pure hinge group (13% vs 6%), significantly influenced by higher body weight. At a mean follow-up of 6.7 years, 21 (13%) patients had a reinfection and underwent a further surgery. Reinfection rates did not differ between the two groups.

CONCLUSION

The use of hinge TKA in the revision of PJI shows favourable five year infection-free and all-cause revision-free survival rates of 91% and 77%, respectively. Our study showed poorer results of the rotating hinge design. These results may help surgeons to choose proper implants in case of septic knee revision.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Liechti, Emanuel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0341-2695

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

02 Apr 2024 08:47

Last Modified:

14 Jun 2024 00:13

Publisher DOI:

10.1007/s00264-024-06139-y

PubMed ID:

38558190

Uncontrolled Keywords:

Hinge knee prosthesis Knee arthroplasty One-stage septic exchange Periprosthetic joint infection Revision arthroplasty

BORIS DOI:

10.48350/195530

URI:

https://boris.unibe.ch/id/eprint/195530

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