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German Congress of Orthopaedics and Traumatology (DKOU 2022)

25. - 28.10.2022, Berlin

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Mid-Term Survival of Primary Rotating Hinge Endo-Modell (Link) Knee Arthroplasty

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  • presenting/speaker Sebastian Schmidt - Arcus Klinik, Pforzheim, Germany
  • Lena Heinings - Arcus Klinik, Pforzheim, Germany
  • Luis Navas - Diakonie Klinikum Stuttgart, Stuttgart, Germany
  • Alexander Zimmerer - Arcus Klinik, Pforzheim, Germany
  • Stefan Weiss - Arcus Klinik, Pforzheim, Germany
  • Matthias Hauschild - Arcus Klinik, Pforzheim, Germany
  • Marcus Streit - Arcus Klinik, Pforzheim, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2022). Berlin, 25.-28.10.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocAB63-1324

doi: 10.3205/22dkou499, urn:nbn:de:0183-22dkou4992

Published: October 25, 2022

© 2022 Schmidt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives: There are only few data on survival and patient reported clinical outcome of the Link Endo-Model rotational hinge total knee arthroplasty (ERH-TKA) in primary total knee arthroplasty. Such information is essential when counselling patients of their likely outcome.

The aim of this retrospective cohort study was (1) to determine the mid-term survival rate, (2) the Patient Related Outcome Measures (PROMs) and patients' satisfaction after primary LINK® Endo-Model® rotational hinge total knee arthroplasty (ERH-TKA) with a mean follow-up of 4 years (minimum follow-up 3 years)

Methods: We evaluated 113 consecutive patients (119 ERH-TKA) with a mean age of 73± 8.8 (40-87) years who underwent primary ERH-TKA between January 2013 and December 2017. Implant survival was estimated using Kaplan-Meier analysis for revision of any cause as primary endpoint. The PROMs were assessed using the Western Ontario and McMaster Universities Arthritis (WOMAC) score and a visual analog scale (VAS) for pain and satisfaction.

Results and conclusion: 20 patients (21 ERH-TKA) died and 6 patients (7 ERH-TKA) were lost to follow-up. Seven knees were revised: Two due to periprosthetic femur fractures (one traumatic and one without adequate trauma), four due to infection (one early prosthetic joint infection and three late prosthetic joint infection) and one secondary retropatellar replacement. No revision was performed for aseptic implant loosening. Survival of primary ERH-TKA after 67 months was 87% (95% CI, range 77.5-92.7%; number at risk: 27) using revision for any cause as the endpoint. Cumulative incidence of revision for infection was 5,6% (1,8- 16,4) at 67 months.

At the last follow-up (mean 57 ±15 (12-100) months) there was a significant improvement in WOMAC score from 38.1 ± 18.5 (8,33-89,58) to 76.7 ± 18.5 (4-100) (p<0.001) and improvement in pain from 7.75± 1.85 (1-10) to 1.87 ± 2.43 (0-8) (p<0.001) on the visual analog scale. Patient satisfaction was 8.1 ± 2.4 (0-10).

The data show acceptable mid-term prosthesis survival rates of primary ERH-TKA. However, revision rates due to infection were higher when compared to the data reported for conventional total knee arthroplasty. Patients should be informed about this fact preoperatively. Furthermore, primary ERH-TKA leads to high satisfaction and significant improvement of PROMs.