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Revised Total Knee Arthroplasty with Total Knee Arthroplasty for stiff knee

Revised Total Knee Arthroplasty with Total Knee Arthroplasty for stiff knee Revised Total Knee Arthroplasty with Total Knee Arthroplasty for stiff knee
Revised Total Knee Arthroplasty with Total Knee Arthroplasty for stiff knee Revised Total Knee Arthroplasty with Total Knee Arthroplasty for stiff knee

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The use of rotating hinge design for revision arthroplasty should be recommended in the selected cases as it allows much more aggressive capsuloligament debridement.

According to the research conducted by the University Hospitals Leuven and Hospital Genk, revision arthroplasty of the stiff knee using a rotating hinged device shows significant outcomes to manage knee osteoarthritis. To treat end-stage knee osteoarthritis, total knee arthroplasty (TKA) endures the gold standard. But, stiffness occurred following the therapy at the rate of 1.3% to 5.3%. The issue can be solved using the revision TKA.

However, revised TKA found to be less favourable for idiopathic arthrofibrosis and stiffening, which can be due to the use of conventional PS or CCK-type revision implants. Therefore, by using a rotating hinge design (RHK) instead of traditional options, better outcomes can be attained, because RHK designs lead to adequate fibrosis removal as it provides more adequate fibrosis removal, while achieving optimal implant stability, flexion-extension space stability, and tibiofemoral rotational freedom. The present study was conducted to evaluate whether a rotating hinge design (RHK) is effective than CCK revision arthroplasty for the stiff total knee arthroplasty.

A total of 40 individuals with a defined range of knee motion selected and individuals with component malposition, underlying mechanical malalignment, infections, and soft-tissue imbalance were excluded. Out of 40 patients, 22 obtained a hinged-type prosthetic device, and 18 got a less constrained condylar type prosthetic device. With RHK, similar preoperative data as CCK-type implants was noticed except for knee pain score, which was considerably worse for the RHK group. The RHK group showed significantly better postoperative outcomes for greater extension gain, knee pain improvement, greater maximal flexion, better maximal extension, greater flexion gain, knee function scores, and knee function improvement as compared to CCK at two years of follow-up. The findings explain that the revised TKA with a rotating hinged device presents a significant impact on arthritis management. 

Source:

The Knee

Article:

Hinged versus CCK revision arthroplasty for the stiff total knee.

Authors:

K. Hermans et al.

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