Clinical Analysis Of Hinge-knee Prosthesis In35Patients

Background and purpose: Clinical analysis of domestic tumorprosthesis was poorly reported. Our aim was to analyze the clinical effects ofdomestic tumor prosthesis and compare the clinical effects betweenfixed-hinge knee an d rotating-hinge knee prosthesis.Methods: Thirty-five patients with tumor prosthesis replacementadmitted to our hospital between April2001and March2013wereretrospectively analyzed. The first group including25patients with domestictumor prosthesis replacement was analyzed through tumor recurrent rate,survival rate, comparison of Knee Society score (KSS) and MusculoskeletalTumor Society score (MSTS) between preoperation and postoperation and theexcellent-good rate, to comprehensively analyze the clinical effects ofdomestic tumor prosthesis. The second group including all35patientsclassified by two types of the prosthesis which were called fixed-hinge kneeprosthesis and rotating-hinge knee prosthesis was analyzed by survival rate,KSS and MSTS before and after operation, flexion-extension angle andcomplication rate to compare the clinical effects between fixed-hinge kneeand rotating-hinge knee.Results: In the first analysis group, the mean follow-up was43.13months, survival rate was80%in3years,69%in5years and46%in10years, mechanical failure rate was12.5%and tumor recurrent rate was29.17%.Before operation the mean KSS pain score was56, the mean KSS functionscore was80.67and the mean MSTS score was13.27. At the end of the lastfollow-up month, the mean KSS pain score was36with the excellent-goodrate33.3%, the mean KSS function score was79with the excellent-good rate66.7%, and the mean MSTS score was23.87with the excellent-good rate80%.In the second analysis group, the mean follow-up of fixed-hinge knee was45.77±7.89months and rotating-hinge knee was23±2.67months; survivalrate of fixed-hinge knee was86%in1years,61%in3years,52%in5yearsand35%in5years while the rotating-hinge knee was88%in1years and63%in2years; mechanical failure rate of fixed-hinge knee was4.5%while therotating-hinge knee was8.3%but the infection rate was16.67%. In thefixed-hinge knee group, the mean KSS pain score was59.62and44.62inpreoperation and postoperation, excellent-good rate38.46%; the mean KSSfunction score was80.92and80.23in preoperation and postoperation,excellent-good rate61.54%; the mean MSTS score was15.23and24.38inpreoperation and postoperation, excellent-good rate84.62%; at the end of thelast follow-up month, the flexion-extension angle was87.92°. In therotating-hinge knee group, the mean KSS pain score was36.5and60.4inpreoperation and postoperation, excellent-good rate60%; the mean KSSfunction score was45.8and71in preoperation and postoperation, excellent-good rate70%; the mean MSTS score was8.1and22.9in preoperation and postoperation, excellent-good rate70%; at the end of the last follow-up month,the flexion-extension angle was102°.Conclusions: It is better to use MSTS to evaluate the clinical effects ofdomestic tumor prosthesis replacement. Domestic tumor prosthesisreplacement is an effective method to treat bone tumors around the knee joint,which can give a satisfactory functional outcome. Rotating-hinge knee systemis superior to the fixed-hinge knee system in clinical effects, but complicationsrate such as infection mechanical problems is high, so the restriction of thesurgery indication should be aware.