Conversion total knee arthroplasty after arthrodesis using rotatory hinge revision system

2019 
Objective Patients with knee arthrodesis experience many daily activities and limitations affecting their life quality. The purpose of this study was to report and discuss the outcome of our cases of knee arthrodesis converted to total knee arthroplasty. Patients and methods In the period from August 2015 to December 2017, the authors conducted a prospective study that included six patients (one female and five males) with sound knee arthrodesis. All patients underwent conversion total knee arthroplasty using rotatory hinge revision system. Patients’ ages ranged from 35 to 66 years. Patients were evaluated using Knee Society Clinical Score and Knee Injury and Osteoarthritis Outcome Score. Results The average follow-up period was 24.5 months (18–36 months). At the final follow-up, average knee flexion was 87.5° (70°–100°). Knee Society Clinical Score and Knee Injury and Osteoarthritis Outcome Score score increased form an average of 31.8 (28.4–34.8) preoperatively to 66.6 (58.6–74.4) at the final follow-up. The authors had an average final Knee society score of 67.6, ranging from 53 to 78. Three cases experienced postoperative complications, representing 50% of the study group, two cases had superficial wound infection, and a case had skin edge necrosis; all were successfully managed, with no long-term complications. Conclusion Conversion total knee arthroplasty is a hope for patients who cannot tolerate the effect of knee arthrodesis in their lives. Awareness of the risks, proper patient selection, good preoperative planning, and adequate management of complications can help the patients to have satisfactory results.
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