Knee arthrodesis for failed total knee arthroplasty

Archives of Surgery (Impact Factor: 4.93). 04/1985; 120(3):350-4.
Source: PubMed


The use of arthrodesis to salvage failed total knee arthroplasty is reviewed in nine patients. Prosthetic failure was due to infection in six cases, aseptic loosening in two cases, and instability in one case. The techniques of arthrodesis included six Hoffman external fixators, two fluted intramedullary rods (3M-Orthopedic Products Division, St Paul), and one pulsing electromagnetic field stimulator. Arthrodesis was successful in eight of nine patients, averaging 5.4 months to union. All eight patients resumed a painfree functional level of activity. Meticulous surgical technique and appropriate method of arthrodesis are emphasized.

1 Follower
6 Reads
  • Source
    • "Patients undergoing knee arthrodesis are often left with limb shortening particularly following large resections, and prior to skeletal maturity, and there are many advocates for performing simultaneous limb lengthening surgery [29,35-38]. The Ilizarov technique has been successfully utilised with bone transport in a series of 5 proximal tibial GCTs, with a mean defect of 5.7 cm [38], and in 7 distal femoral tumors with defects ranging from 8 to 20 cm [37]; others have also successfully used this technique in non-tumor cases, such as knee arthrodesis following infected total knee arthroplasty [39-42]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This case report describes the management of a 15 year old male with a biologically aggressive chondroblastoma of the knee. Following CT, bone scan, angiography and an open biopsy, the diagnosis was confirmed histologically and immunohistochemically. The patient underwent a 13 cm en-bloc excision of the knee, and knee arthrodesis with simultaneous bone transport using an Ilizarov ring fixator. Following 136 days of bone transport, the patient achieved radiological and clinical bony union after a total frame time of 372 days. He then commenced 50% partial weight-bear in a protective knee brace and gradually worked up to full weight-bearing by 4 months. The patient developed superficial pin tract infections around the k-wires on 2 occasions; these settled with a cephalosporin antibiotic spray and local dressings. At 13 years follow-up there are no signs of disease recurrence or failure at the fusion site. The patient is able to fully weight bear and stand independently on the operated leg. Knee arthrodesis with simultaneous limb-lengthening is an effective treatment modality following en-bloc resection of an aggressive chondroblastoma. The case is discussed with reference to the literature.
    Journal of Orthopaedic Surgery and Research 07/2010; 5(1):1-7. DOI:10.1186/1749-799X-5-47 · 1.39 Impact Factor
  • Source
    • "Successful arthrodesis after failed total knee arthroplasty is also difficult to achieve (Knutson et al. 1984, Behr et al. 1985). In our series, 4 out of 5 patients with an arthrodesis continued to experience pain. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Reconstructive surgery was performed in 18 knee arthroplasties because of wound-healing problems or skin necrosis. The procedure, after debridement, included myocutaneous, muscle flap, and split-skin grafts. Revision was necessary in 6 cases. After 1–17 years, 6 patients had died, 2 had had a low femur amputation, and 5 had had an arthrodesis. Five patients had retained the prosthesis, although 3 of them had considerable pain and poor mobility; only 2 patients were tolerably painfree and had acceptable mobility. Patients with an exposed knee endoprosthesis should be referred to centers with special competence in plastic reconstructive surgery.
    Acta Orthopaedica 01/1991; 62(4):312-314. DOI:10.3109/17453679108994459 · 2.77 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Currently the most common indication for an arthrodesis of the knee is a failed infected total knee prosthesis. Other causes of a failed total knee replacement that might necessitate a knee fusion include aseptic loosening, deficient extensor mechanism, poor soft tissues, and Charcot joint. Techniques available for achieving a knee fusion are external fixation and internal fixation methods. The external fixation compression devices have been the most widely used for knee fusion and have been successful until the indications for fusion changed to mostly failed prosthetic knee replacement. With failed total knee replacement, the problem of severe bone loss became an issue, and the external fixation compression devices, even including the biplane external fixators, have been the least successful method reported for gaining fusion. The Ilizarov technique has been shown to achieve rigid fixation despite this bone loss, and a review of reports are showing high fusion rates using this method. Internal fixation methods including plate fixation and intramedullary nails have had the best success in gaining fusion in the face of this bone loss and have replaced external fixation methods as the technique of choice for knee fusion when severe bone loss is present. A review of the literature and a discussion of different fusion techniques are presented including a discussion of the influence that infection has on the success of fusion.
    Clinical Orthopaedics and Related Research 12/2002; 404(404):139-42. DOI:10.1097/00003086-200211000-00024 · 2.77 Impact Factor
Show more