Abstract:

BACKGROUND: The former fixed-hinge design artificial knees have been gradually replaced by rotating-hinge artificial knees due to the high risk of revision. The custom-made rotating hinge artificial total knee can better match the patients’ anatomy and achieve mechanical multiformity and individualized anatomy.
OBJECTIVE: To investigate the clinical effects of custom-made rotating hinge artificial total knee replacement for benignant or malignant bone tumors around the knee.
METHODS: Rotating hinge prosthesis replacement was performed in 19 patients with benignant or malignant bone tumors around the knee, including 13 males and 6 females, aged 19-51 years. There were 6 cases of benignant tumors, 13 of malignant tumors, 15 cases involving distal femur and 4 cases in proximal tibia. Enneking Functional Score was used to evaluate the post-operation functions. Radiographs were shot on the postoperative visit to evaluate the prosthesis conditions and tumor relapse.
RESULTS AND CONCLUSION: The average operating time was (3.64±0.89) hours (range 2.5-5.3 hours) and the average intraoperative blood loss was (452.63±135.88) mL (range 300-800 mL). All the patients were followed-up with an average time of (30.45±21.44) months (range 3-64 months). Local relapse was observed in one patient, and one survived with the presence of lung metastasis. The extension and flexion of knee activity was respectively 0° and 95°-140° (124.47±12.89)°. The excellent and good rate was 89%. Custom-made rotating hinge artificial total knee replacement is an efficacious limb salvage method for the treatment of benignant or malignant bone tumors around the knee.