Does anyone have a hinged knee replacement?

Hmmm......Nobody???

@skybig
I had a hinged knee replacement July of 2024. It was my last option after 3 failed knee replacements, one with infection and one that I broke my femur. I did everything to heal the break, so here I am. My PT had never heard of, or seen a hinged knee before.
Tell me what you are most concerned with in going forward.

My brother in-law is PT with about 40 years experience and he's never seen one either, so they are not very common. My issue that I have a flexure/extension gap issue. As I bend my knee the gap narrows and my knee gets very loose and it dislocates.

What does it feel like to walk around with a hinged knee? Does it feel natural? How far can you bend it? Is it painful?

Thanks

Bob

I had a hinge knee revision in July 2024, after numerous dislocations with my original (2008) knee replacement. I really was not prepared for this by the doctor who performed the surgery. He said, essentially, “it won’t feel the same as the old one.”

This was quite an understatement. My knee does not hurt, but I cannot move it smoothly from overextension (it’s neutral position) to bent. When I put weight on it in the way I put weight on my right knee, it collapses. It’s taken many falls to learn the cautions I need to take to avoid falls.
I was told that rigorous PT to strengthen the surrounding muscles would solve that problem. So far it has not.

Additionally: the tibia and fibula in that same leg were badly broken in an accident many years ago. The tibia healed, stabilized with a compression plate and 6 screws. With the current odd direction of stress on the tibia, I have increasing pain in that bone, which is causing me considerable anxiety. I’m about to go for consultation with another doctor. I have already gone back to the surgeon’s PA twice. She reassured me… but I am not reassured!

Hi. I just posted about my experience with getting a hinge replacement. (Cookiemom, December 7). My best advice: get very thorough information from the doctor, talk to his or her NP or PA and anyone you can find who has had this type of replacement. Often it really is a last resort (I think this was the case with mine, though no one was very straightforward about that), so that has to be taken into account. I try to keep that perspective. I wish you the best of luck - along with patience, humor, and people to talk to. And a great PT!

I honestly can't understand why the doctors keep suggesting that I replace my existing knee replacement with a hinged knee replacement. I just received a second opinion from another surgeon at another hospital, that my issue is that I have flexure/extension gap imbalance. He explained that when I extend my leg straight, my knee is stable and the ligaments are tight. As I bend my knee the gap between the Tibia and Femur narrows. As it narrows my ligaments become loose. So loose that my knee easily dislocates. It has happened three times! The doctor had me flex my knee approximately 90 degrees. Then he grabbed my lower leg and he was able to move it all around. It was shocking how easily and how far he was able to move it around. He said, that movement is the reason why my knee is swollen all the time. He refused to speculate on how this happened, but I now feel that my knee replacement was probably installed incorrectly. So I would think the obvious solution would be to re-install a second kneed replacement only this time insuring that flexure extension gap remains constant. I fail to see why they want to jump to a hinged knee replacement and not a single one of the doctors will explain it to me why they feel this way and that includes the doctor who gave me the second opinion. I'm really getting fed up being treated like a mushroom. Should I be speaking with a lawyer?

Lastly cookiemom I really appreciate your input. Unfortunately, you have confirmed my worst fears about getting a hinged knee replacement. I pray that your knee heals and gets stronger.

It sounds like you need a revision but it is hard to see why you need a hinged knee replacement.

Have you gone to or considered going to the Mayo Clinic, the Cleveland Clinic or the Hospital for Special Surgery for a revision opinion? Alternatively, consider going to one of the great hip/knee surgeons. My incredible surgeon, for example, spends about 20% of his time doing revisions of other surgeons' work.

If a surgeon like mine told me that I needed a hinged knee replacement, I would believe him. But my surgeon met all my requirements for a knee replacement surgeon. Very few do.

Where are you located?

My original knee replacement was done at the Hospital for Special Surgery (HSS) in New York City and so was my revision surgery after my first dislocation. After that I was forced to switch surgeons because my original surgeon didn't accept Medicare, so I was essentially handed off to a doctor I didn't actually choose. I was also told that my case was reviewed by multiple doctors at HSS and apparently all of those agreed that my best option was a hinged knee replacement, but I was never told why they felt that way. They wouldn't even tell me why my knee would dislocates so easily, even after I repeatedly asked. All they would say is that my knee is unstable and never explain why. I had to visit another doctor at another hospital to be told that I had a flexure/extension gap imbalance. Even he couldn't or wouldn't explain how it got that way. I don't know to say this diplomatically so I'll just say it. I no longer trust the doctors over at HSS, especially the ones overseeing my case.

Lastly, hinged knee replacements are not nearly as successful as non-hinged replacements and according to the statistics that I've seen, between 35% to 40% of revision knee replacement surgeries that used a hinged knee replacement don't last 10 years. Frankly those are just terrible odds and I'm not willing to take anymore chances. After the hinged knee fails what would be my option? Would they be able to replace it for a third time or would fusing my leg be my only option? I am so sorry that I went down this path.

I've been told after having my hinged knee for 2 years (if it fails)not that I think it's ever been successful an amputation or fusing are my only other options. I previously had a replacement and a revision less than 2 yrs later. I'm 72. Hoping I don't have to make another decision on it. i.e. hope I die before 80!!!!! Life is not enjoyable as walking moving and all other activities are so dreadfully painful. Will not have my other knee done. Had a great surgeon and sought 2 other opinions. All in agreeance. I'm just the odd man out on this. Sometimes it just sucks!!!!

@skybig

Wow. I would want to avoid a hinged knee if I could and I certainly would want a doctor who answered my questions.

The only thing I can think of is going to another revision surgeon and see if that surgeon sees any alternative to a hinged knee. Don't bring up the hinged knee, just ask if there is anything she can do in a revision. The problem is finding the right surgeon.

My surgeon is a great surgeon (I had zero post surgical pain from both my hip and knee replacements and he put in a bicruciate retaining knee implant which is extremely rare and requires more complex surgery). If my surgeon told me I needed a hinged knee replacement, I would believe him. But it sounds like you are in NYC and he is in Phoenix and he doesn't participate in Medicare either (I had to pay his fee separately). I am confident, in the physician rich northeast corridor, there has to be another surgeon like mine; I just don't know how to find her and, if you do, whether she will be participating in Medicare.