Original Articles
Total knee arthroplasty using the S-ROM mobile-bearing hinge prosthesis*,**

https://doi.org/10.1054/arth.2001.21498Get rights and content

Abstract

A retrospective study was performed on 15 patients receiving 16 S-ROM mobile-bearing hinge total knee prostheses that were evaluated with at least a 2-year follow-up (range, 27-71 months). Indications for its use included severe instability and bone loss. The average patient age was 63 years (range, 33-83 years). There were 15 revision arthroplasties and 1 primary arthroplasty. Knee Society scores showed notable improvement in pain, motion, and stability (33.6 preoperatively vs 76.5 postoperatively; P <.0001) and approached significant improvement in function (29.2 preoperatively vs 43.5 postoperatively; P =.11). After excluding a patient with a traumatically ruptured patellar tendon, the probability of the latter comparison improved (P <.01). There was no evidence of loosening, and complete bone apposition was seen in nearly all cases. A high percentage of satisfactory results can be achieved when using this mobile-bearing hinge knee prosthesis for these indications.

Section snippets

Demographics

A retrospective review was performed on a cohort of 18 consecutive patients with 19 S-ROM mobile-bearing hinge prostheses who were evaluated with at least 2-year follow-up from implantation. Three of these patients had died before the 2-year follow-up and were excluded from the study. Characteristics of the remaining 15 patients (16 knees) and their knees at the time of surgery are listed in Table 1.Surgeries were performed between August 1991 and May 1995, providing a mean follow-up period of

Results

Demographic and knee data are listed in Table 1. The indications for use of the S-ROM mobile-bearing hinge prosthesis were ligamentous instability, bone deficiency, or both in all knees. Because only 1 patient had a primary TKA, scores were not segregated into primary arthroplasty and revision arthroplasty groups. Representative preoperative and postoperative radiographs of 1 patient (No. 2304) are shown in Fig. 2.

. (A) Preoperative lateral and anteroposterior radiographs of failed/infected

Discussion

High complication rates and the inconsistent achievement of successful outcomes with past and some currently available hinge-type prostheses stimulated the development of the S-ROM mobile-bearing hinge prosthesis. This prosthesis has several advanced design features, including i) physiologic valgus, fixed at 7° in the femoral component; ii) modular sleeves and stems for accommodating bone deficits and for enhancing stress transfer into host-bone; iii) porous sleeves, allowing for the

Conclusion

Significant clinical improvement and radiographic evidence of bone maintenance and apposition were shown at nearly 4 years' average follow-up. A high percentage of satisfactory results can be achieved with the S-ROM mobile-bearing hinge knee prosthesis in patients with severe deficiencies in soft tissue stability or hard tissue framework.

Acknowledgements

We are grateful for the assistance of Betty Rostro, Elizabeth Kirch, Shila Ghanbarpour, Sandra Staves, and Georgie Hooker and other support staff at Orthopedic Specialists, Dallas, Texas.

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    *

    Funds were received from Johnson & Johnson Orthopaedics in partial support of the research material described in this article.

    **

    Reprint requests: Richard E. Jones, MD, Center for Joint Restoration, Orthopedic Specialists, LLC, Suite 600, 5920 Forest Park Drive, Dallas, TX 75235.

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