Reliable Outcomes Provided by a Rotating Hinge Knee Arthroplasty for Patients Who Have Moderate-To-Severe Arthrofibrosis
Bibliographic record
Abstract
BACKGROUND: Idiopathic arthrofibrosis after total knee arthroplasty (TKA) is a challenging complication resulting in stiffness and pain. Modern rotating-hinge (RH) prostheses have gained popularity for managing arthrofibrosis during revision TKA. The primary aim of this study was to evaluate the effectiveness of revision TKA using an RH prosthesis on improving range of motion (ROM) for patients who have moderate and severe arthrofibrosis. The secondary aim was to evaluate the survivorship of these prostheses. METHODS: This was a retrospective study of all patients who underwent revision TKA for a diagnosis of arthrofibrosis with an RH prosthesis at a single arthroplasty center between 2014 and 2023. There were 41 patients with a mean follow-up of 3.6 years (SD: 2.5) included. Knee ROM measurements were collected preoperatively, at six weeks, 12 weeks, and one year postoperatively. Postoperative complications were recorded. Differences in arc of ROM for each patient between time points were assessed using analysis of variance. Kaplan-Meier survival analysis with log-rank test was performed for complications requiring reoperation. RESULTS: Mean preoperative ROM, maximum flexion, and maximum extension were 52.7 degrees (SD: 20.1, range, 10 to 90), 68.5 degrees (SD: 21.3, range, 30 to 120), and 15.7 degrees (SD: 14.5, range, 0 to 90), respectively. There was a significantly greater ROM, maximum extension, and maximum flexion at six weeks, 12 weeks, and one year (P < 0.05 for all). At 1 year, mean improvement in ROM was 34.7 degrees (SD: 26.8, range, -34 to 85), and mean ROM was 89.5 degrees (SD: 20.6, range, 46 to 130). Implant survivorship at final follow-up was 90.2%. CONCLUSIONS: Revision TKA with RH prosthesis is effective for the management of idiopathic arthrofibrosis after TKA, resulting in significant improvements in ROM with acceptable short-to-mid-term survivorship. Multicenter, prospective studies with long-term follow-up are warranted to validate these findings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".