Primary total knee arthroplasty with rotating-hinge prosthesis in severely compromised knees

Aim: To evaluate the efficacy of primay total knee arthroplasty (TKA) with a rotating-hinge device in severely compromised knees. Methods: 28 patients who underwent primary TKA with rotating-hinge prosthesis at our institution from 2006 to 2012 were retrospectively reviewed. Indications for the use of a rotating-hinge prosthesis were extreme ligament imbalance or severe bone loss. Clinical evaluations were performed prior to surgery and at the final follow up which included visual analog scale (VAS), Hospital for Special Surgery (HSS) Knee Scores, range of motion (ROM) measurements, assessment of postoperative complications and radiographic data. Data were analyzed with Student's t test with significance at p < 0.05. Results: Mean follow-up period was 6.5 years (range 4-10 years). Mean VAS score decreased from 8.1 (range 6-10) preoperatively to 1.2 (range 0-3) at final follow-up (P=0.01). Mean HSS score improved from 38.5 (range 25-62) preoperatively to 86.3 (range 72-95) at final followup (P=0.02). Average ROM was 64 degrees (range 20-90 degrees) before surgery and 98 degrees (range 90-110 degrees) at final follow-up (P=0.04). There was no malalignment at the final follow-up. No signs of prosthesis subsidence or loosening were observed. Conclusion: Primary TKA using a rotating-hinge prosthesis is effective at improving the pain and function of severely compromised knees.