ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #974

 

Rotating Hinge Knee versus Constrained Condylar Knee in Revision Total Knee Arthroplasty: A Meta-Analysis

Jung-Ro Yoon, MD, PhD, Seoul KOREA, REPUBLIC OF
Young-Soo Shin, MD, PhD, Seoul KOREA, REPUBLIC OF
In-Wook Seo, MD, Seoul KOREA, REPUBLIC OF

VHS Medical Center, Seoul, KOREA, REPUBLIC OF

FDA Status Not Applicable

Summary

In this meta-analysis, we reviewed studies that evaluated pain and function scores, range of motion (ROM), complications, and survival rates in patients treated with RHK or CCK with short-term (<5 years) or midterm (5-10 years) follow-up to compare postoperative scores on knee outcome scales.

Abstract

Background

It is unclear whether rotating hinge knee (RHK) or constrained condylar knee (CCK) prostheses lead to better clinical outcomes and survival rates in patients undergoing revision total knee arthroplasty (RTKA).

Methods

In this meta-analysis, we reviewed studies that evaluated pain and function scores, range of motion (ROM), complications, and survival rates in patients treated with RHK or CCK with short-term (<5 years) or midterm (5-10 years) follow-up to compare postoperative scores on knee outcome scales. The survival time was considered as the time to additional surgical intervention such as removal or revision of the components.

Results

A total of 12 studies met the inclusion criteria and were analyzed in detail. The proportion of the knees in which short-term (<5 years) survival rates (RHK, 83/95; CCK, 111/148; odds ratio [OR] 0.52; 95% CI, 0.24-1.11; P = 0.09) and midterm (5-10 years) survival rates (RHK, 104/128; CCK, 196/234; OR 1.05; 95% CI, 0.56-1.97; P = 0.88) were evaluated did not differ significantly between RHK and CCK prostheses. In addition, there were no significant differences in ROM (95% CI: -0.40 to 9.93; P = 0.07) and complication rates (95% CI: 0.66 to 2.49; P = 0.46). In contrast, CCK groups reported significantly better pain score (95% CI: 0.50 to 2.73; P = 0.005) and function score (95% CI: 0.01 to 2.00; P = 0.05) than RHK groups.

Conclusions

This meta-analysis revealed that 87.4% of RHK and 75.0% of CCK prostheses survive at short-term (<5 years), while 81.3% of RHK and 83.8% of CCK prostheses survive at midterm (5-10 years). Patients treated with CCK prostheses demonstrated significant pain relief and functional improvement compared with patients treated with RHK prostheses