Outcomes of the rotating hinge knee in revision total knee arthroplasty with a median follow-up of 6.2 years

Jake von Hintze, Mika Niemeläinen, Harri Sintonen, Jyrki Nieminen, Antti Eskelinen

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Background: The purpose of this study was to determine the mid-term clinical, radiographic and health-related quality of life (HRQoL) outcomes and define the survival rate in patients who had undergone revision total knee arthroplasty (TKA) using the single rotating hinged knee (RHK) design. Methods: Between January 2004 and December 2013, 125 revision TKAs were performed at our institution using the single RHK implant. We conducted both a retrospective analysis of prospectively collected outcome data of these patients and a prospective follow-up study of all 39 living patients (41 knees). The follow-up phase included an optional extra follow-up visit, PROM questionnaires, and plain radiographs. Results: The ten-year Kaplan-Meier survival rate of the revision RHK knees was 81.7% (95% CI 71.9–91.6%) with re-revision for any reason as the endpoint. Overall, 15 knees (12% of the total) underwent re-revision surgery during the follow-up. The median follow-up was 6.2 years (range, 0–12.7 years) post-operatively for the baseline group. One mechanical hinge mechanism-related failure occurred without any history of trauma or infection. At the time of the final follow-up, the majority of patients evinced a fairly good clinical outcome measured with patient-reported outcome measures and none of the components were radiographically loose. Conclusion: We found that in patients undergoing complex revision TKA, fairly good functional outcome and quality of life can be achieved using an RHK implant. Further, it seems that in this type of patient cohort, revision TKA using an RHK implant relieves pain more than it improves ability to function. The NexGen® RHK design can be regarded as a suitable option in complex revision TKA.

Original languageEnglish
Article number336
JournalBmc Musculoskeletal Disorders
Issue number1
Publication statusPublished - 2021
Publication typeA1 Journal article-refereed


  • Health-related quality of life
  • Hinged knee
  • Knee replacement
  • Patient-reported outcome measures
  • Revision total knee arthroplasty
  • Rotating hinged knee

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Rheumatology
  • Orthopedics and Sports Medicine


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