Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee

Abstract

Background: With the global determination to eliminate tuberculosis (TB), the treatment for end-stage TB of the knee joint is still a great clinical challenge. This study aims to retrospectively determine the clinical and radiographic outcomes after use of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage knee TB. Methods: Twenty-six patients with end-stage knee TB treated by external fixation with the Ilizarov fixator between 2012 and 2017 were examined. Anti-TB drugs were administered preoperatively, intraoperatively, and postoperatively. Clinical and radiologic examinations were performed for comprehensive evaluations, and these include C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), flexion and valgus angle of the knee, leglength discrepancy, and Lysholm score. Results: Twenty-four patients were followed up for an average of 5.8 years (2.2-7 years). All patients achieved bone fusion within a mean of 6.4 months (4-16 months). The ESR and CRP concentrations were observed to return to normal within 5.1 ± 1.1 months postoperatively. There was no recurrence of TB. At last follow-up, the mean leglength discrepancy was 2.7 ± 1.4 cm, and the mean alignment was 8.7 ± 2.6°flexion and 5.3 ± 1.0°valgus. No patient had a significant rotational deformity. The average Lysholm score was seen to improve significantly from 36.8 ± 18.4 preoperatively to 79.5 ± 5.9 at final follow-up (p < 0.0001). Conclusion: This study has demonstrated that the Ilizarov technique for knee joint arthrodesis as a treatment of end-stage knee TB achieved promising outcomes with minimal complications.

Application of a Modular Fixing Device for Arthrodesis Following Periprosthetic Femoral Fracture With Comorbid Pathology: A Clinical Case

“…Техніки артродезу колінного суглоба добре задокументовані, але частота ускладнень коливається від 20% до 84%. Хоча післяопераційні ускладнення є звичайним явищем, існує мало інформації щодо варіантів лікування цих ускладнень [3,4,9].…”

Optimization of a Patient-Specific External Fixation Device for Lower Limb Injuries

“…Various types of external fixators were developed for specific types of fractures, including planar, circular and hybrid external fixators [ 12 ]. These different external fixators, designed with different stiffness and stability characteristics, can be classified according to their frame configurations as unilateral, bilateral, quadrilateral, triangular, semi-circular, and circular [ 13 , 14 , 15 ]. The stiffness of the external fixators is critical to heal the fracture quickly and properly [ 9 , 16 ], but the optimal stiffness has not been identified yet.…”