[GUEPAR hinge knee prosthesis (author's transl)]

Abstract

Early and late results of Guepar hinge knee prosthesis have been evaluated on a serie of 184 operations performed before January 1st 1974. There were 3 immediate deaths and 26 before 5 years. 19 prosthesis were removed. 126 knees had degenerative osteoarthritis, 52 rheumatoid arthritis. 22 had been operated on before. Patellar displacement, present in 27 p. 100 of the cases was the most frequent cause of complaint: pain or instability, proportional to the severity of displacement made reoperation necessary in 10 p. 100 of the patients. Addition of a patellar prosthesis was the most successful treatment as far as pain is concerned: it is probably advisable as a primary procedure. Deep infections occurred in 8,3 p. 100 of the cases, unfrequently after 2 years. Healing was obtained in all cases either by revision or by removal and arthrodesis: but functional results were poor except when fusion was achieved, in half of the cases of arthrodesis. Loosening occurred in 16 p 100 of the cases mainly as the consequence of insufficient technique. It was frequently tolerated: reoperation was necessary in 6 p. 100 of the total. Late functional results were evaluated in 99 cases with a follow-up of 5 to 8 years. Apart from loosening, the results did not deteriorate. 60 p. 100 are evaluated as excellent or good, 29 p. 100 fair, and 11 p. 100 bad. With due consideration of these results election of this prosthesis should be limited to special cases. To prevent complications, the use of a patellar prosthesis, of reinforced models, and of cementing under pressure is advisable.