Table 9.
Literature review about septic revision managed with hinged prosthesis.
| Study (date) | Number of septic revisions with hinged prosthesis (Number of patients in the cohort) | Surgical strategy | Mean follow-up [min-max] | Type of implant | Survival | Functional outcomes | Post-operative complications |
|---|---|---|---|---|---|---|---|
| Pradhan et al. (7) | 23 (51) | 2-stage | 4 years [2-6] | Endo-Model® | np | Pre-operative HSSa score:32 Post-operative HSSa score: 70 |
- moderate pain: 3/23 - Amputation for septic recurrence: 1/23 - 6 plastic surgeries - persistent pain and stiffness: 1/23 |
| Deehan et al. (33) | 11 (72) | 2-stage | 10 years [3-18] | Howmedica Kinematic rotating hinge | 90% at 5 years follow-up, across indications | Across indications: Knee Society Score 28–74 | −18% (2/11) of reinfections following septic revision - Across indications: persistent pains (14%), extensor apparatus dysfunction (7%), Infection (7%), Peri-prosthetic fracture (4%) |
| Molenaers et al. (34) | 29 (66) | 2 stages | 5 years [2-12] | Finn/OSS Biomet | 92% at 5 and 10 years, across indications | KSSb +27 points KSSb pain + 12 points KSSb function +20 points |
−1 septic recurrence - Other septic revisions complications unspecified |
| Smith et al. (35) | 46 (111) | Np | Np | - Kinematic 1 Stryker - Kinematic 2 Stryker - Duracon Total Knee System-Modular Rotating Hinge, Stryker - S-ROM Revision Hinge Knee, DePuy - Finn Hinge Knee Rotating Platform System Biomet |
77% at 1-year follow-up, 52% at 5 years follow-up, across indications | Np | Across indications: - 63 % complications - 24% infection - 12% soft tissue complications (extensor apparatus and/or scar) - 7% aseptic loosening - 5% peri-prosthetic fracture |
| Shen et al. (9) | 29 (94 hinged prosthesis, 381 non-hinged prosthesis) | Np | 6 years [3-10] | Np | - Better functional outcomes of hinged TKA in patients with AORId type II bone loss in septic indication - Improved WOMACc score for hinged TKA in patients with AORId type III bone loss in septic indication |
||
| Farid et al. (36) | 60 (142) | 2 stages | 57 months [24-163] | OSS Biomet | 78.4% | Np | −2-staged revision failure: 21.0.6% - Any cause failure: 26% - Reoperation: 38.5% - Aseptic loosening: 9.2% - Mechanical complications of the hinge: 6.1% - Extensor apparatus complications: 6.1% - Peri-prosthetic fracture 6.1% - Femoral stem fracture: 7.7% |
| Cottino et al. (37) | 144 (408) | 2 stages | 48 months [24-144] | - Howmedica modular rotating hinge - NexGen RH Knee Zimmer - S-ROM Noiles rotating Hinge Depuy - Finn Rotating Hinge Biomet |
Across indications: - 84.5% at 5 years follow-up - 71.3% at 10 years follow-up |
Across indication: KSSb: from 51 to 81 KSSb function: from 26 to 36 |
Across indications: - Infection (11%) - Delayed wound healing (3%) - Stiffness (2.5%) - Aseptic loosening (2.5%) - Superficial infection (1.2%) |
HSSa
score de l'Hospital Special Surgery.
KSSb
Knee Society Score.
WOMACc: score Western Ontario McMaster.
AORId: Anderson Orthopaedic Research Institute.
Np, no precisions.