Dislocation of rotating hinge knee prostheses. A report of four cases.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to Paul Ritchie.
Explore the source record for details and available documents.
Shoulder instability in the competitive athlete is a relatively common problem. The etiology of glenohumeral instability that can affect the athlete runs a wide spectrum, from an isolated traumatic dislocation to repeated microtrauma or congenital laxity. Although many athletes are able to adapt to a mild laxity that might only occasionally affect them, it can be much more difficult to adapt or return to play after a dislocation or repeated subluxation episodes. This article focuses on the return to play for competitive individuals after a glenohumeral dislocation or reconstructive surgery for shoulder instability.
BACKGROUND: Symptomatic instability and implant dislocation are occasionally encountered in patients with a rotating hinge total knee prosthesis. A biomechanical study of rotating hinge total knee implants was performed to determine the association between the design (length and taper) of the central rotational stem and the stability of the implant. METHODS: The stem lengths and tapers of knee implants made by seven manufacturers were measured. The tilting laxity of each design was tested by measuring the degree of tilting of the central rotational stem within the tibial housing that occurred with increasing amounts of distraction. The maximum amount of distraction that was possible before the stem dislocated was determined for each design. RESULTS: Implant designs with a short and/or markedly tapered central rotational stem had the greatest tilting, laxity, and instability of that stem. The Howmedica, Techmedica, Intermedics/Sulzer Medica, and Wright Medical Technology/ Dow Corning Wright designs required > or = 39 mm of distraction before they dislocated. The Biomet knee implant required 33 or 44 mm of distraction to dislocate, depending on the thickness of the polyethylene tray that was utilized. The S-ROM knee required only 26 mm of distraction before dislocation occurred. CONCLUSIONS: The measurements confirmed that the shorter the stem and the greater its taper, the greater the instability and laxity at any given amount of joint distraction.