Total knee arthroplasty using the kinematic rotating hinge prosthesis.

Patients receiving a Kinematic Rotating Hinge total knee prosthesis with a 25-month minimum follow up were reviewed. A total of 46 patients and 54 knees were included in the study. A detailed clinical assessment was available on 38 knees. Twenty of these knees had primary arthroplasties performed with the Kinematic Rotating Hinge prosthesis and 18 knees had revision arthroplasty. Ninety-five percent of primary knees and 83% of revision knees caused no or mild pain postoperatively. Using the Brigham and Women's Hospital and Harvard Medical School knee rating system, 80% of primary knees and 61% of revision knees were rated as good to excellent. Using the criteria defined in this article, 90% of primary knees and 83% of revision knees were labeled as having a satisfactory result. Forty-five percent of primary components and 52% of revision components demonstrated lucent lines on radiographic review. Seven percent of primary knees and 20% of revision knees showed evidence of aseptic lucency progression in one or more zones. No radiographic evidence of aseptic loosening was noted in this review. Documented sepsis occurred in one primary knee and two revision knees. Patellar instability occurred in 21% of primary knees and 36% of revision knees, representing the major complication. The Kinematic Rotating Hinge prosthesis is intended for use in arthroplasty cases where there is functional absence of collateral ligament stability. This review suggests that a high percentage of satisfactory clinical results can be achieved with this prosthesis with long-term radiographic stability.