Distraction osteogenesis as a salvage method in infected knee megaprostheses

Hatzokos, Ippokratis; Stavridis, Stavros I.; Iosifidou, Eirini; Petsatodis, George; Christodoulou, Anastasios

doi:10.1016/j.knee.2010.08.001

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…The 95% confidence intervals for complication rate is (0.006-0.327). The results of the treatment are in agreement with those of the previous studies, which used various arthrodesis techniques for infected knees or total knee arthroplasty failure (mean fusion rate, 64-100%; mean fusion time, 4.5-12.4 months; complication rate, 43-100%) [38][39][40][41][42]. The inflammation index including white blood cell count, ESR, and CRP returned to normal after an average of 5.1 months postoperatively, which is consistent with previous reports [43].…”

Section: Discussionsupporting

confidence: 89%

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

Sun¹,

Li²,

Gao³

et al. 2020

BMC Musculoskelet Disord

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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.

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Section: Discussionsupporting

confidence: 89%

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

Sun¹,

Li²,

Gao³

et al. 2020

BMC Musculoskelet Disord

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“…However, if the recommendations are observed, this does not worsen the result obtained. 13 The result obtained by us on the terms of treatment, the period of fixation is not inferior to the literature data.…”

Section: 18mentioning

confidence: 49%

“…All the authors describe complications, characteristic for external fixation -pin-tract infection 11,12 and, in a number of cases, secondary foot deformity after tibia lengthening. 13,15,18,19 The results of the SF-36 scale indicated that treatment significantly improved both the physical and psychological quality of life of patients.…”

Section: Discussionmentioning

confidence: 99%

“…9 Revision surgery, the installation of the hinge model of the Endoprosthesis -all this increases the risk of infection. 13 Therefore, complications of endoprosthetics are currently the most frequent reasons for performing arthrodesis of the knee joint, when the presence of chronic osteomyelitis is a contraindication to performing revision endoprosthetics. 8 The shortening of the operated limb after arthrodesis of the knee joint, after joint replacement according to different authors ranges from 1.5 to 6.4cm.…”

Section: Discussionmentioning

confidence: 99%

“…8,14 In case of the large bone defect forming the knee joint after removal of cancer endoprosthesis staged reconstructive interventions are recommended. 8,13,15,16 There is strong evidence that arthrodesis of the knee joint is preferable to amputation. 8,15 Amputation after total endoprosthetics of the knee joint significantly reduces the quality of life, due to the impaired ability to move.…”

Section: Discussionmentioning

confidence: 99%

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Ilizarov bone transport in large knee joint defect (case report)

Соломин¹,

Korchagin²,

Tyulkin³

et al. 2018

OAJTMR

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The large knee joint defects (LKJD) are one of the indications to amputation and prosthesis. Alternative to it is reconstructive surgery based on Ilizarov method. We present the case of a female patient with LKJD 16cm and shortening of the right lower extremity 12cm, hypertrophic distraction regenerate of the right lower limb 6cm and chronic osteomyelitis of the right femur. The whole period of treatment was 67 months (5.5 years). Period of osteosynthesis (period of distraction and fixation) was 43 months (3.5 years). The complications that we faced during the treatment had no influence on good final anatomical and functional results.

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