The SMILES prosthesis in salvage revision knee surgery.

Revision total knee arthroplasty using a second generation modular rotating hinge design was done on thirty two knees in 30 patients over an 8-year period. Twenty-nine knees in 29 patients were followed up for 4.5-11 years (mean, 58 months). Four prostheses failed and two patients had died and one patient was lost to followup. Indications for revision were recurrent sepsis (five knees), component failure (four knees), ligamentous instability (two knees), aseptic loosening (10 knees), fracture (six knees), and gross bone loss (five knees). Early results have demonstrated improvement in both the Knee Society knee and function Scores and range of movement. The Knee Society knee score improved from 26 preoperatively to 68 postoperatively. The function score improved from 27 preoperatively to 75 postoperatively. One patient had evidence of aseptic loosening on radiographs, and the patellofemoral complication rate was low at 6%. This short-term clinical and radiographic review has demonstrated encouraging results in the use of a custom-made second generation rotating hinge component when used in revision knee surgery.