Abstract:

The popularity of prostheses, the annual increase in revision patients and the successful application of limb salvage surgery for bone tumors have led to an increase in the number of patients with the application and potential application of hinge knee prostheses. Hinge knee prosthesis is a means to reconstruct the failure of the stability mechanism of the internal and external ligaments of the joint. It has undergone three generations of evolution from the uniaxial movement of fixed hinge, the biaxial movement of rotating hinge, and multi-axial movement of spherical axis. The motion mode of the hinge knee prosthesis goes through uniaxial movement of fixed hinge, biaxial movement of rotating hinge, and multi-axial movement of spherical axis hinge. Loading modes range from full hinge load, to increased condylar load ratio and then full condylar load. The limitations and constraints of the prosthesis gradually decrease, the biomechanical distribution becomes more reasonable, stress concentration is reduced, the probability of wear, loosening, and fracture is declined, the survival rate of the prosthesis is improved, and complications are lowered. However, compared with primary total knee arthroplasty prostheses, hinge prostheses have poorer long-term outcomes. This article summarized the evolution of hinge knee prostheses in motion and loading modes, and to provide references and ideas for prosthetic research and design.

Key words: Knee prosthesis, Motion, Weight-bearing, Joint instability, Biomechanical phenomena, Stress, mechanical, Prosthesis failure, Prosthesis design, Survival rate