Dauwe Jan, Vandenneucker Hilde
Acta Orthop Belg. 2018 Sep;84(3):245-250.
The use of rotating-hinge systems in total knee arthroplasty is most often seen in revision setting where excessive bone loss, ligamentous instability and/ or extensor mechanism dysfunction may necessitate an increased level of component constraint. However, this implant type is also being increasingly used in the primary setting. The aim of this study is to review literature concerning the use of third generation rotating-hinge devices focusing on the indications for primary cases. Literature was searched for following search terms: total knee arthroplasty, primary indication, constraint, rotating hinge knee, knee prosthesis, hinged knee, total knee replacement. Additional papers were identified by screening references and similar articles. All papers dealing with first or second generation rotating-hinge implants and revision cases were discarded. After conducting a large literature search, we concluded that third generation rotating-hinge implants should be considered in limited indications in which ligamentous tibiofemoral instability is the core indication.
全膝关节置换术中旋转铰链系统的应用最常见于翻修手术中，此时过度的骨质流失、韧带不稳定和/或伸肌机制功能障碍可能需要增加假体的约束程度。然而，这种假体类型在初次手术中也越来越多地被使用。本研究的目的是回顾关于第三代旋转铰链装置应用的文献，重点关注初次手术病例的适应证。使用以下检索词进行文献检索：全膝关节置换术、初次适应证、约束、旋转铰链膝关节、膝关节假体、铰链膝关节、全膝关节置换。通过筛选参考文献和类似文章确定了其他论文。所有涉及第一代或第二代旋转铰链植入物以及翻修病例的论文均被排除。在进行大规模文献检索后，我们得出结论，第三代旋转铰链植入物应仅在有限的适应证中考虑使用，其中胫股韧带不稳定是核心适应证。
