Functional outcome of knee arthrodesis with a monorail external fixator

Roy, Alfred Cyril; Albert, Sandeep; Gouse, Mohamad; Inja, Dan Barnabas

doi:10.1007/s11751-016-0247-5

Cited by 10 publications

(4 citation statements)

References 9 publications

(10 reference statements)

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“…One common issue is leg length discrepancy post-surgery, a consequence of shortening the affected limb to enhance bone healing at the fusion site. Studies have reported limb shortening ranging from approximately 2.5 to 5.4 cm associated with knee arthrodesis procedures [6][7][8][9][10][11]. A second concern is the frequent insu ciency of autologous bone available for patients undergoing this procedure [12,13].…”

Section: Introductionmentioning

confidence: 99%

The use of antibiotic-loaded bone cement combined with tibial intramedullary nail as last resort treatment in 11 elderly patients with knee joint bone infection

Li,

Zhang,

et al. 2024

Preprint

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Background The management of bone infections has always posed a challenge in the field of orthopedics, and geriatric knee joint bone infections are even more difficult. In this study, we aimed to assess the clinical efficacy of using antibiotic-loaded bone cementcombined with tibial intramedullary nail as a last resort treatment option for geriatric knee joint bone infection patients. Methods The retrospective study was conducted on 11 elderly patients with knee joint bone infection. The cohort comprised 3 male and 8 female patients, with an average age of 74.27±3.47years. Of these patients, 4 patients experienced reinfection after knee revision replacement, while 7 patients had knee joint bone infection.After stage-1 infection control, all patients underwent a stage-2 treatment using antibiotic-loaded bone cement combined with tibial intramedullary nail as the ultimate treatment approach. Results All patients’ infections were effectively controlled. The average length of bone defect after debridement was 12.09±1.22cm. The duration of the stage-2 operation averaged180.27±11.06minutes. Postoperatively, there was no significant discrepancy in the length of the patients’ lower limbs. All patients experienced a significant enhancement in knee joint function, as indicated by the decrease in WOMAC scores from 141.45±11.75preoperatively to 79.09±0.34postoperatively. Pain levels saw a profound reduction, plummeting from 26.27 ± 2.45 to a non-existent 0.00 ± 0.00. Additionally, there was a substantial improvement in performing daily activities, rising impressively from 59.09 ± 0.34 to 100.55 ± 8.37. However, an increase in joint stiffness was noted, worsening slightly from 15.45 ± 1.63 to 20.00 ± 0.00.One case of peri-implant fracture occurred. Conclusion Antibiotic-loaded bone cement combined with tibial intramedullary nailing as last resort treatment can be considered as an alternative surgical option for elderly patients with knee joint bone infection who have experienced multiple failed operations and long-term knee stiffness.

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Section: Introductionmentioning

confidence: 99%

The use of antibiotic-loaded bone cement combined with tibial intramedullary nail as last resort treatment in 11 elderly patients with knee joint bone infection

Li,

Zhang,

et al. 2024

Preprint

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“…EFs have been used in several other treatment domains such as in reconstructive orthopaedics and fracture care. EFs are used for arthrodesis [ 68 ], treatment of failing or failed femoral plating [ 69 ], infected non-union fracture (femoral shaft) [ 70 ], treatment of bone loss [ 71 , 72 ], deformity correction [ 73 – 75 ] and treatment of osteomyelitis [ 76 ].…”

Section: Introductionmentioning

confidence: 99%

“…A study was conducted among patients with severe and recurrent congenital talipes equinovarus deformities, it showed that complete correction was obtained using (Ilizarov) EFs and had relatively few complications [ 79 ]. An EF is a safe and economically feasible procedure for reconstructive surgery of Charcot feet, and it improves activity level, minimises complications, and reduces secondary amputation [ 68 , 75 ].…”

Section: Introductionmentioning

confidence: 99%

Use of external fixators in developing countries: a short socioeconomic analysis

Pathmanathan

Wijesinghe

Silva

2022

Cost Eff Resour Alloc

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The use of external fixators (EFs) dates back to 377 BC Hippocrates’ time, and it has a wide range of orthopaedic applications. External fixator has expanded its use in the management of fractures and other musculoskeletal conditions. It is widely used all over the world to manage complex musculoskeletal injuries. It has many advantages as compared to internal fixation in some trauma scenarios. However, the cost of the external fixators presents a dilemma to the healthcare system in developing countries. The goals of this review article are to explain the importance of EFs in developing countries in managing fractures, to determine the problems encountered at present during external fixation by developing countries, to identify solutions that could be used to address these issues, expand the use of external fixation into other domains of treatment, the impact of COVID-19 pandemic on fracture management based on existing literature. In conclusion, EFs are very expensive, researches have been conducted to overcome these barriers in developing countries. However, there are limitations in implementing in developing countries. It is important to have affordable and clinically acceptable EFs available in developing countries.

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“…Ironically, clinical interest in knee arthrodesis procedures and outcomes remains constant, and there are a large number of published case reports and review articles (Somayaji et al 2008 ) on the subject. Some of these reports have focused on the conflicting methods of achieving fusion, including external fixation (Ravi and Chaikof 2010 ; Spina et al 2010 ; Roy et al 2016 ) and internal fixation by means of intramedullary nails (Leroux et al 2013 ; Lee et al 2012 ; Razii et al 2016 ) or dynamic compression plates (Roy et al 2016 ; Lv et al 2012 ). Clinical evidence indicates that internal fixation tends to be a simpler procedure; however, external fixation can be indicated in cases of substantial bone or tissue loss (Lee et al 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Knee arthrodesis: procedures and perspectives in the US from 1993 to 2011

2016

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BackgroundThe incidence and prevalence of knee arthrodesis (fusion) in the United States is largely unknown, in spite of numerous case reports and review articles that have called attention to this life altering procedure.PurposeThis study was conducted to determine long-term knee arthrodesis incidence and patient populations, and to characterize the associated healthcare burden.MethodsThe Nationwide Inpatient Sample was used to evaluate knee arthrodesis procedures performed in the United States between 1993 and 2011. Patient age, sex, and reimbursement method were evaluated along with hospital attributes. Procedural rates for individual demographics were calculated using population data from the US Census. Commonly occurring diagnoses and procedures in knee arthrodesis were compiled.ResultsThe annual number of reported knee arthrodesis procedures remained relatively unchanged between 1993 and 2011 (Mean 1014, Standard Deviation 113), but there was a small but significant decrease in the procedure rate when taking population changes into account. Over 80 % of patients were aged 45 or above. Approximately 65 % of patients utilized governmental payers for reimbursement. Nearly all of the procedures were performed in metropolitan area hospitals (92.5 %), and a significant majority performed in teaching hospitals (62 %).ConclusionsThe low incidence of knee arthrodesis procedures reflects both clinician and patient antipathy for this undesirable surgery. Case studies continue to reflect an interest to improve methodology, but also suggest a significant number of patients that go untreated given the current state of the art. Future work should seek to quantify the prevalence of patients with a severely dysfunctional knee who might otherwise undergo arthrodesis, but opt against it given the significant quality of life issues associated with the procedure.

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Functional outcome of knee arthrodesis with a monorail external fixator

Cited by 10 publications

References 9 publications

The use of antibiotic-loaded bone cement combined with tibial intramedullary nail as last resort treatment in 11 elderly patients with knee joint bone infection

The use of antibiotic-loaded bone cement combined with tibial intramedullary nail as last resort treatment in 11 elderly patients with knee joint bone infection

Use of external fixators in developing countries: a short socioeconomic analysis

Knee arthrodesis: procedures and perspectives in the US from 1993 to 2011

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