Analysis of an on-going prospective study of seventy-seven hinged total
knee arthroplasties in sixty-seven patients revealed that most patients had
improvement in function, although major complications occurred in eighteen
knees (23.4 per cent). These complications included sepsis, loosening,
patellar tendon rupture, peroneal palsy, and patellar subluxation. Eight of
nine knees with deep sepsis required removal of the prosthesis, and three of
sixteen knees with patellar pain required realignment of the quadriceps. When
prosthetic failure occurred, salvage of a functional extremity was difficult.
Hinged total knee arthroplasty is not without its problems, and a cautious
approach to its use is indicated. Whenever possible, a moderately constrained
replacement arthroplasty should be considered.