Arthrodesis of the knee with a vascularized fibular rotatory graft.

Allograft-Prosthetic Composite in the Proximal Tibia After Bone Tumor Resection

“…Knee fusion, in its various reconstructive forms, allows a simpler and faster operation. If autoplastic grafts or vascularized transplantations are used, it will be stable and permanent but at the direct expense of the loss of knee movement [5,11,15,30]. The use of an APC might be the best Each author certifies that he or she has no commercial associations (e.g., consultancies, stock, ownership, equity interest, patent/licensing arrangements, etc.)…”

Is There a Role for Knee Arthrodesis With Modular Endoprostheses for Tumor and Revision of Failed Endoprostheses?

“…The earliest biologic arthrodeses were performed using external fixation systems, intramedullary devices, and hybrid methods with union rates from 38% to 100% and different complications [1,13,17,19,22,24,32,33,36,45,48]. Vascularized fibulae have been used to augment arthrodesis reconstructions of all types with overall excellent results [29,31,37,46]. Septic knee arthritis and failed, septic TKA often require débri-dement of large volumes of bone, necessitating structural intercalary segments to maintain limb length when arthrodesis is performed [25].…”

“…However, we did not observe a significant difference between failure rates of primary arthrodeses for tumors compared with revision procedures of a prior implant with segmental bone loss. Although success rates of 80% to 100% have been reported after primary, biologic arthrodesis in patients without prior TKA [9,14,19,30,31,37,44], the success rate of arthrodesis performed in patients with an infection at the site of a TKA has been reported to be much lower [8]. However better results in terms of complication rates have been reported using metal implants than biologic reconstruction [2,8,9,11,13,23,33,42,45,47].Whereas Gosheger et al reported no infections in three arthrodeses with the MUTARS 1 implant [16] and Bartlett et al reported one infection in 10 Stanmore implants [3], there were nine infections in our 31 patients.…”

Resection arthrodesis of the knee with a vascularised fibular graft

“…Our primary rate of union of 83% and overall rate of union of 100% compares favourably with other reports. 12,16 The time to union was shorter than that reported when using autogenous or allograft techniques. 5,6,9 De Boer and Wood 14 reported an incidence of stress fractures of 59% in patients undergoing vascularised fibular grafts without associated intramedullary fixation whereas the incidence of stress fractures in our series in this group was 100%.…”