Rotating-Hinge Revision Total Knee Arthroplasty for Treatment of Severe Arthrofibrosis

Joshua S. Bingham, Brandon R. Bukowski, Cody C. Wyles, Ayoosh Pareek, Daniel J. Berry, Matthew P. Abdel

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Revision total knee arthroplasty (TKA) for arthrofibrosis is fraught with challenges. Because rotating-hinge (RH) prostheses do not rely on ligaments for stability, a more aggressive soft-tissue release is possible. The goal of this study was to report arc of motion, Knee Society scores, and implant survivorship in patients with arthrofibrosis revised with an RH. Methods: Thirty-four patients revised with an RH for arthrofibrosis were matched to 68 patients revised without an RH. The mean age was 63 years, 62% were female, mean body mass index was 31 kg/m2, and mean follow-up was 6 years (range, 2-15 years). Results: The mean arc of motion increased 20° (74°-94°) in the RH group versus 12° (87°-99°) in the non-RH group (P = .048). Two manipulations under anesthesia were performed in the RH group compared to 9 in the non-RH group (P = .2). Knee Society scores increased significantly in both groups (P = .01 and P < .001, respectively). Survivorship free of revision for aseptic loosening at 10 years was 83% in the RH group versus 96% in the non-RH group (P = .44). Survivorship free of any revision at 10 years was 54% in the RH group and 90% in the non-RH group (P = .03). Forty percent of the revisions in the RH group were related to insert and bushing exchanges. Conclusion: In this series, patients with arthrofibrosis revised to an RH TKA had a 20° improvement in arc of motion and manipulations under anesthesia were half as common. However, there was a higher risk of re-revision in the RH group. Level of Evidence: III.

Original languageEnglish (US)
Pages (from-to)S271-S276
JournalJournal of Arthroplasty
Issue number7
StatePublished - Jul 2019


  • arthrofibrosis
  • complications
  • revision total knee arthroplasty (TKA)
  • rotating-hinge prosthesis
  • stiffness

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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