Department of Orthopaedic Surgery, Seoul Veterans Hospital, 6-2 Dunchon Dong, Kangdong Ku, Seoul, Korea.
Knee Surg Sports Traumatol Arthrosc. 2012 Mar;20(3):517-23. doi: 10.1007/s00167-011-1590-1. Epub 2011 Jul 20.
A rotating-hinge total knee prosthesis may be utilized for the treatment of global instability or severe bone loss around the knee. The outcome of primary total knee arthroplasty (TKA) using Endo-Modell (Link(®)) rotating-hinge prosthesis was evaluated.
Retrospectively, review of 50 cases (40 patients) at a mean follow-up of 15 years (range, 10-18) who underwent primary TKA using Endo-Modell (Link(®)) was performed. Indications included severe primary osteoarthritis with substantial ligament laxity, severe rheumatic arthritis with extreme ligament instability and bone loss, supracondylar nonunion, charcot arthropathy, and posttraumatic arthritis. Knee Society Score (KSS) and radiographic analysis were done for preoperative and at latest follow-up. Statistical analysis was done using the Student's t test with the level of significance of p < 0.05.
Overall, the rotating-hinge arthroplasty resulted in improved knee functioning. The KSS improved (p < 0.001) from a preoperative mean of 38 ± 14.3 (SD) points to a postoperative mean of 73 ± 12.8 points; the functional score improved (n.s.) from 36 ± 19.5 points to 47 ± 23.5 points. Mean range of motion at the most recent clinical follow-up evaluation was 102 ± 9°. However, all (100%) patients needed some form of assisted devices for walking and a relatively large number of deep infections (14%) were encountered.
Reconstruction with a rotating-hinge total knee prosthesis provided substantial improvement in function and reduction in pain. However, the possibility of assisted walking and high rate of deep infection should be encountered.
Retrospective therapeutic study, Level IV.
旋转铰链式全膝关节假体可用于治疗膝关节周围的整体不稳定或严重骨丢失。评估了使用 Endo-Modell（Link（®））旋转铰链假体进行初次全膝关节置换术（TKA）的结果。
回顾性分析 50 例（40 例患者）的病例，平均随访 15 年（范围 10-18 年），这些患者均接受了 Endo-Modell（Link（®））初次 TKA。适应证包括严重原发性骨关节炎伴明显韧带松弛、严重风湿性关节炎伴极度韧带不稳定和骨丢失、髁上不愈合、夏科关节炎和创伤后关节炎。术前和末次随访时进行膝关节学会评分（KSS）和影像学分析。使用 Student's t 检验进行统计学分析，显著性水平为 p < 0.05。
总体而言，旋转铰链关节置换术可改善膝关节功能。KSS 显著改善（p < 0.001），从术前平均 38 ± 14.3（SD）分提高到术后平均 73 ± 12.8 分；功能评分无显著改善（n.s.），从术前 36 ± 19.5 分提高到术后 47 ± 23.5 分。末次临床随访时平均活动范围为 102 ± 9°。然而，所有患者（100%）都需要某种形式的助行器行走，并且遇到了相对较高比例的深部感染（14%）。
旋转铰链式全膝关节假体重建可显著改善功能并减轻疼痛。然而，应考虑到辅助行走的可能性和较高的深部感染率。
回顾性治疗研究，IV 级。
