A New Hinge Prosthesis Offers Ease of Use and the Ability to Retain the Revision Tibial Baseplate.

Abstract

Total knee arthroplasty (TKA) is a widely practiced surgical procedure, with its efficacy underscored by the increasing number of patients benefiting from it. As primary TKAs rise, the orthopaedic community must prepare for a surge in complex primary and revision knee arthroplasties in the future. While most revisions use non-constrained or semi-constrained prostheses, certain scenarios require a fully constrained (hinge) prosthesis to address major ligamentous and/or bone loss. Over time, hinge designs have evolved, but outcomes with these designs have been mixed. To help address challenges seen with some earlier designs, a new modular revision solution has been designed for both primary and revision surgeries. This system has a new revision baseplate that has compatibilities with varying distal femoral components and introduces an enhanced hinge mechanism. This paper aims to explore the evolution of hinge designs, elaborate on the surgical workflows and intended compatibilities of this new revision hinge system in six different scenarios, and discuss its various potential advantages.