Knee arthrodesis as last resort for persistent knee joint infections

Zajonz, Dirk; Zimmerlich, Benedikt; Möbius, Robert; Edel, Melanie; Przybyl, Johanna; Höch, Andreas; Fakler, Johannes K. M.; Röth, Andreas; Ghanem, Mohamed

doi:10.1007/s00132-020-03939-z

Cited by 5 publications

(5 citation statements)

References 37 publications

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“…Fusion was defined as bony trabeculae traversing from the tibia to the femur in at least two radiographic projections. It was reported after IMN in nine studies [8,15,21,22,24,29,[31][32][33] and occurred in 192 out of 267 patients (71.9%). In the EF group, fusion was reported in seven studies [13,14,16,20,24,26,29] and occurred in 130 out of 165 (78.8%) patients.…”

Section: Fusion Reoperation and Amputation Ratesmentioning

confidence: 97%

“…It was reported after IMN in nine studies [8,15,21,22,24,29,[31][32][33] and occurred in 192 out of 267 patients (71.9%). In the EF group, fusion was reported in seven studies [13,14,16,20,24,26,29] and occurred in 130 out of 165 (78.8%) patients. Fusion after CP was reported in two studies [13,29] and occurred in 12 out of 13 patients (92.3%).…”

Section: Fusion Reoperation and Amputation Ratesmentioning

confidence: 97%

“…In the EF group, fusion was reported in seven studies [13,14,16,20,24,26,29] and occurred in 130 out of 165 (78.8%) patients. Fusion after CP was reported in two studies [13,29] and occurred in 12 out of 13 patients (92.3%). No statistically significant differences were found among the groups.…”

Section: Fusion Reoperation and Amputation Ratesmentioning

confidence: 99%

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Knee Arthrodesis for Periprosthetic Knee Infection: Fusion Rate, Complications, and Limb Salvage—A Systematic Review

Mercurio,

Gasparini,

Cofano

et al. 2024

Healthcare

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The aim of this systematic review was to investigate the outcomes of knee arthrodesis (KA) after periprosthetic joint infection (PJI) of the knee. Differences in clinical outcomes and complication rates among the intramedullary nailing (IMN), external fixation (EF), and compression plating (CP) procedures were compared. A total of 23 studies were included. Demographics, microbiological data, types of implants, surgical techniques with complications, reoperations, fusion, and amputation rates were reported. A total of 787 patients were evaluated, of whom 601 (76.4%), 166 (21%), and 19 (2.4%) underwent IMN, EF, and CP, respectively. The most common causative pathogen was coagulase-negative Staphylococcus (CNS). Fusion occurred in 71.9%, 78.8%, and 92.3% of the patients after IMN, EF, and CP, respectively, and no statistically significant difference was found. Reinfection rates were 14.6%, 15.1%, and 10.5% after IMN, EF, and CP, respectively, and no statistically significant difference was found. Conversion to amputation occurred in 4.3%, 5%, and 15.8% of patients after IMN, EF, and CP, respectively; there was a higher rate after CP than after EF. The IMN technique is the most common option used for managing PJI with KA. No differences in terms of fusion, reinfection, or conversion-to-amputation rates were reported between IMN and EF. CP is rarely used, and the high amputation rate represents an important limitation of this technique.

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Section: Fusion Reoperation and Amputation Ratesmentioning

confidence: 97%

Section: Fusion Reoperation and Amputation Ratesmentioning

confidence: 97%

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Knee Arthrodesis for Periprosthetic Knee Infection: Fusion Rate, Complications, and Limb Salvage—A Systematic Review

Mercurio,

Gasparini,

Cofano

et al. 2024

Healthcare

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“…1,2 Treatment options for PJI include suppressive antibiotics, open debridement with insert exchange, single-stage or two-stage revision surgery, and knee arthrodesis. [1][2][3][4] Knee arthrodesis is considered a last resort for persistent knee joint infections and provides stability and pain relief by fusing the knee joint. 5 However, knee arthrodesis eliminates the possibility of future joint motion and may require the use of assistive devices for mobility.…”

Section: Introductionmentioning

confidence: 99%

“…5 The best management of PJI is still highly debated, and the success rates of different treatment options vary. [1][2][3][4] Factors that can affect treatment success include the severity of the infection, the patient's overall health, and the presence of comorbidities. 1,2…”

Section: Introductionmentioning

confidence: 99%

Arthrodesis following persistent periprosthetic knee infection using femoral condyle allograft: a case report and review of literature

Vaz Pinto,

Marques Luís,

Ribeiras Cabral

et al. 2024

Int J Res Orthop

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Periprosthetic joint infections (PJI) of the knee are difficult to treat and can require costly and prolonged hospital stays, weeks or months of antibiotic therapy, and multiple surgical procedures. Knee arthrodesis is considered a last resort for persistent knee joint infections and provides stability and pain relief by fusing the knee joint. The authors describe a case of a persistent and difficult to treat periprosthetic total knee arthroplasty (TKA) infection, subjected to multiple surgeries and revisions, where an arthrodesis was performed as a last resort. The arthrodesis was performed using a femoral-tibial endomedullary nail with interposed femoral condyle allograft. Complete graft integration and consolidation was achieved without complications. The patient performed well post-operatively and is currently ambulatory with walking aids and has no knee pain. The removal of well-fixed metaphyseal sleeves in TKA can be challenging and associated with complications such as damage to the surrounding bone and soft tissue during the removal process. Taking special care and not rushing this step can present an extremely meaningful difference in the final outcome. In cases with large bone defects, especially after sleeve removal, allograft usage can be extremely useful for managing dead space and limb-length discrepancies while promoting faster bone healing. When successful, as was the case described, arthrodesis using allografts can have beneficial outcomes with high patient satisfaction and deliver function to previously very unhealthy joints and limbs.

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Low complication rate and better results for intramedullary nail - arthrodesis for infected knee joints compared to external fixator—a series of one hundred fifty two patients

Suda

Brachtendorf

Tinelli³

et al. 2021

International Orthopaedics (SICOT)

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Knee arthrodesis as last resort for persistent knee joint infections

Cited by 5 publications

References 37 publications

Knee Arthrodesis for Periprosthetic Knee Infection: Fusion Rate, Complications, and Limb Salvage—A Systematic Review

Knee Arthrodesis for Periprosthetic Knee Infection: Fusion Rate, Complications, and Limb Salvage—A Systematic Review

Arthrodesis following persistent periprosthetic knee infection using femoral condyle allograft: a case report and review of literature

Low complication rate and better results for intramedullary nail - arthrodesis for infected knee joints compared to external fixator—a series of one hundred fifty two patients

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