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La prothèse de genou à charnière rotatoire est une option pertinente dans l’arthroplastie primaire. Revue de la littérature et méta analyse

2019; Elsevier BV; Volume: 105; Issue: 7 Linguagem: Inglês

10.1016/j.rcot.2019.09.026

1877-0525

Ali Abdulkarim, Anna Keane, Shu Yang Hu, Lachlan Glen, Dermot Murphy,

Knee injuries and reconstruction techniques

Rotating-hinge knee replacements are usually reserved for revision surgeries, when the extent of soft tissue loss makes a constrained implant more suitable. They remain an uncommon choice in primary surgery when the soft tissue loss is not as extensive. We completed a systematic review and meta-analysis to assess patients who underwent a Total Knee Replacement (TKR) with the rotating-hinge prosthesis in the primary setting. We searched PubMed and Embase for articles published in the ten years prior June 2017: prosthesis survival rates, causes of failure, and clinical/functional scores were the primary outcomes. Twenty-one articles met the inclusion criteria for meta-analysis. Articles were grouped into (1) non-tumour (n = 11) and (2) tumour indications (n = 10). Survival data was summarized in forest plots, generated using Stata. We found that for certain indications the prosthesis has impressive survival rates and functional outcomes. Short-term (1–5 year) prosthesis survival in non-tumour cases was 92% (95% CI, 87–98%) and 77% (95% CI, 68–87%) in tumour cases. Mid-term (6–10 year) survival was 82% (95% CI, 74–89%) and 69% (95% CI, 57–81%) in non-tumour and tumour studies respectively. In analysis of clinical scores, patients showed a significant improvement in their pain score. Infection was the most commonly cited cause of prosthesis failure in both non-tumour and tumour studies, attributing to 31.5% and 37.6% of failures respectively. Aseptic loosening, dislocation and fracture were also commonly cited complications. We concluded that the rotating-hinge knee prosthesis is a viable option in primary surgery when there is extensive soft tissue destruction surrounding the joint. I.