Arthrodesis of the Knee Following Failed Arthroplasty

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2013 May 28

PMID 23708381

Citations 19

Authors

P J H van Rensch

G J Van de Pol

J H M Goosen

A B Wymenga

F H R De Man

Affiliations

Soon will be listed here.

Abstract

Purpose: Primary stability in arthrodesis of the knee can be achieved by external fixation, intramedullary nailing or plate fixation. Each method has different features and results. We present a practical algorithm for arthrodesis of the knee following a failed (infected) arthroplasty, based on our own results and a literature review.

Methods: Between 2004 and 2010, patients were included with an indication for arthrodesis after failed (revision) arthroplasty of the knee. Patients were analyzed with respect to indication, fusion method and bone contact. End-point was solid fusion.

Results: Twenty-six arthrodeses were performed. Eighteen patients were treated because of an infected arthroplasty. In total, ten external fixators, ten intramedullary nails and six plate fixations were applied; solid fusion was achieved in 3/10, 8/10 and 3/6, respectively.

Conclusions: There is no definite answer as to which method is superior in performing an arthrodesis of the knee. Intramedullary nailing achieved the best fusion rates, but was used most in cases without--or cured--infection. Our data and the contemporary literature suggest that external fixation can be abandoned as standard fusion method, but can be of use following persisting infection. The Ilizarov circular external fixator, however, seems to render high fusion rates. Good patient selection and appropriate individual treatment are the key to a successful arthrodesis. Based upon these findings, a practical algorithm was developed.

Citing Articles

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Novel, static, permanent spacers to treat chronic knee periprosthetic joint infections.

Li S, Meng Y, Pan J, Sun Y Int Orthop. 2023; 47(10):2585-2589.

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Knee Arthrodesis: An Analysis of Surgical Risk Factors and Complications Using a National Database.

Denyer S, Hoyt A, Schneider A, Brown N Arthroplast Today. 2023; 20:101098.

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Wide resection and reconstruction in a low resource area, cemented nail technique knee arthrodesis; a report of case and surgical technique.

Mohammed Hassan Elbahri H, Abd-Elmaged H, Abdulkarim M, Ahmed M, Medani M Int J Surg Case Rep. 2022; 99:107621.

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Diagnosis and management of infected arthroplasty.

Pannu T, Villa J, Higuera C SICOT J. 2021; 7:54.

PMID: 34723789 PMC: 8559719. DOI: 10.1051/sicotj/2021054.

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