Postoperative Alignment in Hinge Total Knee Arthroplasty - "Are Hinge Knees too Valgus?"

Ryan S Bailey; Christopher Halbur; Trevor R Gulbrandsen; Timothy S Brown; Nicolas O Noiseux

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Postoperative Alignment in Hinge Total Knee Arthroplasty - "Are Hinge Knees too Valgus?"

Journal article

Open access

Peer reviewed

Postoperative Alignment in Hinge Total Knee Arthroplasty - "Are Hinge Knees too Valgus?"

Ryan S Bailey, Christopher Halbur, Trevor R Gulbrandsen, Timothy S Brown and Nicolas O Noiseux

The Iowa orthopaedic journal, Vol.45(1), pp.75-79

2025

PMCID: PMC12212337

PMID: 40606690

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https://pmc.ncbi.nlm.nih.gov/articles/PMC12212337/View

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Abstract

Hinged knee prostheses are a potentially beneficial treatment approach in complex primary and revision total knee arthroplasty (TKA). Previous reports have demonstrated good long-term outcomes and survivorship with appropriate indications. However, adequate restoration of joint line and limb alignment remain challenging, with the implant design playing a significant role. Optimal limb alignment is generally within 0° to 3° of the mechanical axis. However, little data exists on limb alignment results following hinged knee procedures. The aim of this study was to evaluate the limb alignment of patients following hinged TKA. A retrospective review was performed of 117 operations in 114 patients who received a TKA with hinged prosthesis at one academic institution between 2008 and 2021. Ten were excluded due to inadequate follow-up or imaging, leaving 107 procedures in 104 patients for analysis. Demographics, indications, and postoperative weight-bearing radiographs were analyzed. Alignment measurements included the mechanical axis (hip-knee-ankle angle) and anatomic tibiofemoral axis. Mean patient age was 67.6 years (range: 36-90), 59% were female. Mean BMI was 35.2 kg/ m2. Mean mechanical alignment was 0.53° ± 3.33 valgus (range 12.55° valgus to 8.42° varus) and 6.18° ± 2.82 valgus (range 16.3° valgus to 1.62° varus) for anatomic. Nineteen patients (18%) had a postoperative mechanical alignment >3 degrees valgus, and 9 patients (8%) were greater than 3 degrees varus. The incidence of valgus malalignment is greater than varus following TKA with a hinged prosthesis. Future studies should focus on the impact of alignment on patient reported outcomes. .

Adult

Aged

Aged, 80 and over

Arthroplasty, Replacement, Knee - adverse effects

Arthroplasty, Replacement, Knee - instrumentation

Arthroplasty, Replacement, Knee - methods

Bone Malalignment - etiology

Female

Humans

Knee Joint - diagnostic imaging

Knee Joint - surgery

Knee Prosthesis

Male

Middle Aged

Prosthesis Design

Retrospective Studies

Details

Title: Subtitle: Postoperative Alignment in Hinge Total Knee Arthroplasty - "Are Hinge Knees too Valgus?"
Creators: Ryan S Bailey - University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Christopher Halbur - University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Trevor R Gulbrandsen - University of Iowa
Timothy S Brown - University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Nicolas O Noiseux - University of Iowa
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.45(1), pp.75-79
Publisher: The University of Iowa
PMID: 40606690
PMCID: PMC12212337
ISSN: 1555-1377
eISSN: 1555-1377
Language: English
Date published: 2025
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984843593002771

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