TABLE VI.
Summary of Major Previous Reports on Rotating-Hinge Knee Replacement in Bone Tumor Surgery*
| Revision Rate Per Failure Type | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Report | Institution | No. of DFR Cases |
Prosthesis | Follow-up (yr) | Type 1 | Type 2 | Type 3 | Type 4 | Type 5 | Implant Survival/Cumulative Incidence of Failure |
Analysis |
| Pala et al.9, CORR, 2015 | Instituto Rizzoli | 187 | GMRS (Stryker) | Mean, 4 (range, 2-8) | 8.5% | 5.7% | NR | 9.3% | 5.7% | Implant survival, 73% and 60% at 4 and 8 yr | Kaplan-Meier; RH followed max. 8 yr |
| Pala et al.18, Int Orthop, 2016 | Instituto Rizzoli | RH, 196 | GMRS (Stryker) | Mean, 7.9 (range, 0-27) | 6.1% | 2.0% | NR | 6.6% | 4.6% | Kaplan-Meier; mixture of femoral/tibial cases; mixture of RH/FH; RH followed max. 7 yr | |
| Myers et al.8, JBJS Br, 2007 | Royal Orthopaedic Hospital | RH, 174; FH, 161 | Custom (Stanmore) | Unknown for RH; mean, 12 (range, 5-30) for RH and FH survivors | NR | NR | NR | NR | NR | Cumulative incidence of failure for RH, 17% and 22% at 5 and 10 yr | Kaplan-Meier; mixture of RH/FH; RH followed max. 12 yr |
| Bickels et al.4, CORR, 2002 | George Washington University and Tel-Aviv University | 102 | Custom and modular (Howmedica) | Median, 7.8 (range, 2-16.5) | NR | 5.4% | NR | 5.4% | NR | Implant survival, 93% and 88% at 5 and 10 yr | Kaplan-Meier; most cases censored at <5 yr |
| Morgan et al.7, CORR, 2006 | University of Washington | 76 | Modular (several manufacturers) | Median 4.8 (range, 0.1-19.6) | NR | 17.1% | NR | 41.9% | NR | Implant survival, 73% and 59% at 5 and 10 yr | Kaplan-Meier; most cases censored at <5 yr |
| Coathup et al.5, JBJS, 2013 | Royal National Orthopaedic Hospital | 61 | Custom (Stanmore) | Mean, 8.5 (range, 2-16) | NR | 8.0% | 3.0% | 3.0% | 5.0% | Implant survival, 75%, 84%, and 89% at 5, 10, and 15 yr | Kaplan-Meier; most cases censored at <5 yr |
| Batta et al.2, BJJ, 2014 | Royal National Orthopaedic Hospital | 69 | Custom (Stanmore) | Mean, 10.4 (range, 0.3-17.7) | 7.0% | 13.0% | 10.0% | 7.0% | 4.0% | Implant survival, 73%, 65%, and 55% at 5, 10, and 15 yr | Kaplan-Meier; most cases censored at <5 yr |
| Schwartz et al.10, CORR, 2010 | UCLA | 186 | Custom, 54; GMRS, 46% (several manufacturers) | Mean, 8.0 (range, 0.1-28.0) | NR | 29.0% | NR | 3.2% | NR | Implant survival, 77% at 10 yr (survival without revision) | Kaplan-Meier; several different prostheses; most cases censored at <5 yr |
| Bus et al.1, CORR, 2017 | Leiden University | 89 | MUTARS (implantcast) | Mean, 7.2 (range, 0.4-18) | 6.0% | 16.0% | 14.0% | 13.0% | 10.0% | Cumulative incidence of failure, 30%, 37%, and 54% at 5, 10, and 15 yr | Competing risk analysis; several different prostheses; most cases censored at <5 yr |
| Current study | MSK | 214 | Finn/OSS (Biomet) | Mean, 12.4 for survivors (9.1 overall) | 0% | 15.0% | 10.7% | 10.3% | 1.4% | Cumulative incidence of failure, 22.6%, 30.1%, 34.4%, and 42.5% at 5, 10, 15, and 20 yr | Competing risk analysis; no mixture of RH/FH; no mixture of femoral/tibial cases; used single prosthesis (Finn/OSS) |
*
DFR = distal femoral replacement, GMRS = Global Modular Replacement System, NR = not reported, RH = rotating hinge, FH = fixed hinge, UCLA = University of California Los Angeles, MUTARS = Modular Universal Tumor And Revision System, MSK = Memorial Sloan Kettering Cancer Center, and OSS = Orthopaedic Salvage System.