Twenty-seven hinged (Guepar II) knee replacements were performed on 26 patients with a follow-up of 1 to 7 years (mean 3 years). Indications for the procedure were bone loss (nine cases) nonunion of tibial or femoral fractures (four), anteroposterior instability (five), mediolateral instability (eight) and recurvatum instability (one). Results were good or excellent in 66.6%. Two patients required revision and there were three other implant-related complications. All press-fit stems were radiolucent to some extent and some radiolucency was present close to the knee in all revisions of stem components. No radiolucency was present in revisions of non-stem cemented components. Although the introduction of variable stem length, semi-constrained knees has reduced the need for implants such as the Guepar II prosthesis, the results, especially in terms of radiolucency, are surprisingly good. The authors conclude that a hinged knee remains of value in desperate situations.