Between December 2002 and December 2007, we retrospectively assessed the mid term results of the Nexgen rotating hinge prosthesis in the hands of a single surgeon in difficult primary and complex revision situations. Forty four patients (46 knees) were included in the study: they were followed for an average of 62 months. Knee Society knee score improved from a preoperative mean value of 47 to a mean value of 81 at follow-up (p < 0.05) whereas the mean function score improved from 17 (0-40) to 67.5 (0-90) at follow-up (p < 001). Mean flexion range improved from 65 degrees to 96 degrees at follow-up (p < 0.05). In conclusion, rotating hinge knees gave satisfactory results in difficult revision situations associated with major bone loss, instability or periprosthetic fracture. They also provided satisfactory results in selected cases of advanced primary osteoarthritis.

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