The use of a modular rotating hinge component in salvage revision total knee arthroplasty

Revision total knee arthroplasty (TKA) using a second-generation modular ro tating hinge design was performed on 16 knees in 15 patients over a 5-year period. Follow-up of 2 to 6 years (mean, 51 months) was obtained in 14 knee s in 13 patients. Indications for revision were aseptic loosening of a hing ed prosthesis (8 knees), loosening and bone loss associated with chronic ex tensor mechanism disruption (2 knees), component instability with chronic m edial collateral ligament disruption (3 knees), and comminuted distal femur fracture (1 knee). Clinical and radiographic results were reviewed and com pared with 87 patients who underwent revision TKA using a standard condylar revision design during the same period. Early results showed comparable po stoperative knee scores and range of motion between the 2 groups despite th e use of the rotating hinge component in more complex revision cases. No pa tient has exhibited radiographic evidence of definite component loosening. Alignment of 5 degrees to 10 degrees of valgus in the frontal plane and wit hin 2 degrees of neutral in the sagittal plane was achieved consistently. S hort-term clinical and radiographic results are encouraging and suggest tha t a second-generation modular rotating hinge component can be used successf ully in selected salvage revision cases.