Original ArticlesTotal knee arthroplasty using the S-ROM mobile-bearing hinge prosthesis*,**
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.
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.
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Reprint requests: Richard E. Jones, MD, Center for Joint Restoration, Orthopedic Specialists, LLC, Suite 600, 5920 Forest Park Drive, Dallas, TX 75235.