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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(01): e68-e75
DOI: 10.1055/s-0044-1779685
Artigo Original
Joelho

Comparative Functional and Isokinetic Analysis between Implants with Posterior Stabilization and Rotating Hinge Total Knee Arthroplasty

Article in several languages: português | English
Sandra Tie Nishibe Minamoto 
1   Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia. Rio de Janeiro, RJ, Brasil
,
Alan de Paula Mozella 
1   Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia. Rio de Janeiro, RJ, Brasil
,
Victor Rodrigues Amaral Cossich 
1   Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia. Rio de Janeiro, RJ, Brasil
,
Ubiratã Faleiro Gavilão 
1   Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia. Rio de Janeiro, RJ, Brasil
,
Heitor Schuabb Machado 
1   Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia. Rio de Janeiro, RJ, Brasil
,
João Maurício Barretto 
2   Grupo de Joelho do Hospital São Vicente, Rede D'Or, Rio de Janeiro, RJ, Brasil
› Author Affiliations Financial Support There was no financial support from public, commercial, or non-profit sources.
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Abstract

Objective: To compare the function and muscle strength of the limb between patients undergoing knee arthroplasties using primary implants with posterior stabilization (control group) and patients with rotating hinge implants (Hinge group).

Methods: Function assessment was performed using the Knee Society Score (KSS) and muscle strength using an isokinetic dynamometer using a speed of 60°/s.

Results: 43 patients were analyzed, who underwent 51 surgeries, with the Hinge group comprising 25 surgeries and the control group comprising 26 primary surgeries. We did not observe significant differences between the Hinge and control groups in the values of functional KSS (p = 0.54), objective KSS (p = 0.91), peak flexor torque (p = 0.25) and peak extensor torque (p = 0.08). Patients in the Hinge group who underwent primary arthroplasties had a higher peak flexor torque (0.76 Nm/kg) than those who used the implant in revision after septic failure (0.33 Nm/kg) (p < 0.05). The constrained implant was indicated in arthroplasty revision surgeries with severe ligament instability and in cases of complex primary arthroplasties with bone destruction or severe coronal deformity in the coronal plane.

Conclusion: The use of constrained implants enables joint function and muscle strength comparable to patients who underwent primary arthroplasty using conventional implants with posterior stabilization. Patients undergoing septic revision with a rotating Hinge prosthesis exhibit lower flexor muscle strength compared to those undergoing primary arthroplasty with a constrained implant.

Keywords

arthroplasty, replacement, knee - osteoarthritis, knee - muscle strength

Work developed at the INTO – Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ, Brazil.




Publication History

Received: 23 November 2021

Accepted: 26 June 2023

Article published online:
21 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
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