Clinical Application Of Rotating Hinge Knee Arthroplasty In Complex Gonarthrosis

Objective: To analyze and discuss the clinical effect of the application of rotating hinge knee arthroplasty in complex gonarthrosis. Methods: From may 2003 to October 2006,11 cases(12 knees) of complex gonarthrosis were treated with Endo-Model rotating hinge knee arthroplasty. Of these 11 cases, there were 3 males and 8 females(9 knees)with an average age of 55.2 years(range from 37 to 73 years). The diagnoses were rheumatoid arthritis in 5 cases(6 knees),severe osteoarthritis in 3 cases, traumatic arthritis in 1 case, development malformation and secondary osteoarthritis due to joint infection in childhood in 1 case, giant cell tumor of bone of proximal tibia in 1 case. The results were evaluated with the knee score system of special surgical hospital of New York ( HSS ). Results: All the 11 cases were followed, with an average of 24.1 months (ranged from 6 months to 42 months). The average HSS score increased from 35.83 preoperatively to 90.25 postoperatively. After the operation,pain, varus-valgus and flexion contracture deformity disappeared, and range of joint motion were from 0°to 125°.All the sufferer can walk without crutch. Among the general evaluation : 10 cases(10 knees) were excellent,1 cases(2 knees) were good, the excellent rate was 83.3%.1 case of traumatic arthritis had residual genu anterior ache. Conclusions: Rotating hinge knee arthroplasty has an perfect short-term effect in treating severe genu deformity, articular instability due to ligament injury, bone defect and salvage operation for bone tumor. It can relieve pain,correct deformity, improve joint function and increase life quality. Carefull preoperative preparation,skilled operation technique and perfect postoperative rehabilitation methods are vital to achieve a good result.