Rotating hinge total knee arthroplasty in severely affected knees

A consecutive series of 24 knees in 21 patients who received a Finn rotatin g hinge for primary (nine knees) or revision (15 knees) total knee arthropl asty between August 1993 and January 1997 was reviewed. The average followu p was 33 months (range, 21-62 months) for all patients in the study. Sevent een patients (20 knees) were followed up for more than 2 years. Twenty-four knees (21 patients) were categorized according to Knee Society scoring cri teria: 37.5% (nine knees) were Category A, 25% (six knees) were Category B, and 37.5% (nine knees) were Category C. Using the Knee Society knee and fu nction scores, clinical and radiographic results were assessed and outcome analysis was determined. The average Knee Society knee score improved from 44 points (range, 5-64 points) before surgery to 83 points (range, 45-95 po ints) after surgery; the average functional score according to the Knee Soc iety system improved from 10 points (range, 0-35 points) before surgery to 45 points (range, 0-100 points) after surgery. Pain and function markedly i mproved after surgery. For treatment of the most severely affected knees wi th compromised bone and ligamentous instability, the Finn total knee replac ement appears to be an acceptable option. As a rotating hinge design, the p rosthesis at early followup provides excellent pain relief, restoration of walking capacity, and stabilization, without evidence of early mechanical f ailure.