Abstract

GOMEZ, Diego J; GARABANO, Germán; SENES, Sebastián  and  PESCIALLO, César A. Luxación de una prótesis abisagrada de rodilla: Reporte de un caso. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2017, vol.82, n.4, pp.294-298. ISSN 1852-7434.

Hinged knee prosthesis has a complication rate up to 44% at 15 years. Prosthetic dislocation secondary to a breakage of the hinged mechanism turns to be the second most frequent late complication after mechanical loosening. We present a patient with a posterior dislocation of a third generation rotating hinged total knee replacement (Rotax, FII SA®, Saint Just Malmont, France), implanted originally in a 69-year-old woman with rheumatoid arthritis and history of treatment with metilprednisone and methotrexate at high doses. The bilateral arthroplasty was performed in two times to correct a highly disabling deformity. We hypothesize the dislocation is due to the breakage of the polyethylene yoke of the prosthesis, being the weakest link of the hinged mechanism. There are rare bibliographic reports about this complication. However, we found similar conclusions, considering the engage of the tibial and femoral components as the weakest link of the system. We recommend in these complex scenarios to perform revision surgery only in cases with high repercussion in daily life presenting persistent instability or multiple dislocations.

Keywords : Hinged knee prosthesis; Posterior prosthetic dislocation; Implant rupture; Failure of a hinged prosthesis; Disengagement; Revision total knee arthroplasty; Yoke fracture.

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