Improved clinical outcomes after revision arthroplasty with a hinged implant for severely stiff total knee arthroplasty

摘要

PurposeManagement of the severely stiff total knee arthroplasty (TKA) is challenging, with the outcome of revision arthroplasty being inferior compared to the outcome for other indications. The aim of this study was to analyse the outcome after revision TKA with hinged-type implants for severely stiff TKA [range of motion (ROM)70 degrees] at 2years.MethodsA cohort of 38 patients with a hinged-type revision TKA (Waldemar Link or RT-Plus) and preoperative ROM70 degrees were selected from a prospectively collected database. ROM, visual analogue scale (VAS) for pain and satisfaction and Knee Society Score (KSS) were obtained preoperatively and at 3months, 1year and 2years. Pre- and postoperative outcome were compared at 2years.ResultsThere was a significant increase in ROM and KSS. VAS pain scores did not differ significantly. The median ROM at 2years was 90 degrees (range 50 degrees-125 degrees) with a median gain of 45 degrees (range 5 degrees-105 degrees). Median VAS pain was 28.5 (range 0-96) points and median VAS satisfaction was 72 (range 0-100) points at 2years. Twelve patients suffered a complication. Recurrent stiff knee was the most frequently reported complication (n=5).ConclusionsHinged-type revision TKA following a severely stiff TKA renders a significant, although moderate, clinical improvement at 2years.Level of evidenceRetrospective case series. Level IV.