Knee Arthrodesis in the Infected Total Knee Arthroplasty

Razii, Nima; Kakar, Rahul; Morgan–Jones, Rhidian

doi:10.1007/978-3-319-66730-0_20

Cited by 4 publications

(6 citation statements)

References 78 publications

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“…It can only be undertaken in the presence of relatively small bone defects and involves removal of any infected prosthetic material and thorough debridement of the synovium, with no further reimplantation. The more common alternatives to permanent resection arthroplasty include arthrodesis or AKA [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Compared with bony fusion, the development of a fibrous ankylosis is predictably less stable and has less load-carrying capacity, so ambulation is more difficult. However, a resection arthroplasty will generally allow a limited range of movement and is therefore likely to be more comfortable for sitting [ 11 ]. This is especially relevant to case 2, where the patient’s frailty meant that she needed to use a wheelchair.…”

Section: Discussionmentioning

confidence: 99%

“… Anteroposterior (a) and lateral (b) right knee radiographs at 3 years following resection arthroplasty, with established fibrous ankylosis. (Reprinted from Razii et al [ 11 ], with permission from Springer Nature). …”

Section: Case Reportmentioning

confidence: 99%

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Permanent Resection Arthroplasty of the Knee as Limb Salvage Following Recurrent Periprosthetic Infection Complicated with Osteomyelitis

Razii,

Morgan-Jones

2023

jocr

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Introduction: Permanent resection or excision arthroplasty of the knee involves the removal of any infected prosthetic material and thorough debridement, with no further reimplantation. The more common alternatives to permanent resection arthroplasty include knee arthrodesis or above-knee amputation (AKA). Case Report: We describe two cases of complex periprosthetic infections of the knee associated with subsequent osteomyelitis, which were unsuitable for re-revision arthroplasty. Both patients chose to remain with an excision arthroplasty, rather than undergo arthrodesis or AKA, respectively, and were satisfied with their quality of life at long-term follow-up. Conclusion: Although permanent resection arthroplasty of the knee is rarely performed, it remains a limb salvage option in certain cases where bone loss is limited, functional demands are low, and further surgery may present a significant risk. Keywords: Knee, resection arthroplasty, excision arthroplasty, revision, periprosthetic infection, osteomyelitis, limb salvage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Permanent Resection Arthroplasty of the Knee as Limb Salvage Following Recurrent Periprosthetic Infection Complicated with Osteomyelitis

Razii,

Morgan-Jones

2023

jocr

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“…KF may be viewed as favorable because patients retain the potential for bipedal ambulation without a prosthetic leg. However, QOL may not be superior [ 33 , 34 ]; 5.9% of patients may remain infected, 14.6% may lose ambulatory capacity, 18.8% of ambulatory patients may require assistive devices, and 50% of patients may have additional unplanned surgeries. Regarding TKR PJI amputees, only 25% may walk at 38.5 months following amputation [ 6 ], 55.9% primarily use a wheelchair for mobility, 79.5% have phantom pain, 47.1% require chronic pain medications, and only 52.9% were satisfied with their QOL [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Osseointegration Following Transfemoral Amputation After Infected Total Knee Replacement: A Case Series of 10 Patients With a Mean Follow-up of 5 Years

et al. 2022

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“…Different techniques for knee arthrodesis have been reported including intramedullary nails, external fixators and compression plates [9][10][11][12]. Intramedullary nails of different length and modularity are the most used method for knee arthrodesis, which is mainly correlated with good results [13].…”

Section: Introductionmentioning

confidence: 99%

Knee Arthrodesis with a Modular Silver-Coated Endoprosthesis for Infected Total Knee Arthroplasty with Extensive Bone Loss: A Retrospective Case-Series Study

Savvidou,

Kaspiris,

Goumenos

et al. 2023

JCM

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Introduction: Knee arthrodesis is a limb salvage intervention for persistent periprosthetic joint infection (PJI) when revision total knee arthroplasty fails. Conventional arthrodesis techniques are associated with the increased rate of complications, especially in patients with extensive bone loss and extensor tendon deficiency. Methods: Eight patients with a modular silver-coated arthrodesis implant after failed exchange arthroplasty for infection, were retrospectively reviewed. All patients had significant bone loss, while 5 displayed extensor tendon deficiency. Survivorship, complications, leg length discrepancy, median Visual Analogue Scale (VAS) and Oxford Knee score (OKS) were evaluated. Results: The median follow up was 32 months (range 24–59 months). The survivorship rate of the prosthesis was 86% during the minimum time of follow up of 24 months. In one patient recurrence of the infection was observed and above-knee amputation was performed. The median postoperative leg length discrepancy was 2.07 ± 0.67 cm. Patients were able to ambulate with mild or no pain. The median VAS and OKS was 2.14 ± 0.9 and 34.7 ± 9.3, respectively. Conclusions: The results of our study demonstrated that knee arthrodesis with a silver coated arthrodesis implant, performed for persistent PJI in patients with significant bone loss and extensor tendon deficit, provided a stable construct, allowed eradication of infection and was associated with good functional outcome.

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Knee Arthrodesis in the Infected Total Knee Arthroplasty

Cited by 4 publications

References 78 publications

Permanent Resection Arthroplasty of the Knee as Limb Salvage Following Recurrent Periprosthetic Infection Complicated with Osteomyelitis

Permanent Resection Arthroplasty of the Knee as Limb Salvage Following Recurrent Periprosthetic Infection Complicated with Osteomyelitis

Osseointegration Following Transfemoral Amputation After Infected Total Knee Replacement: A Case Series of 10 Patients With a Mean Follow-up of 5 Years

Knee Arthrodesis with a Modular Silver-Coated Endoprosthesis for Infected Total Knee Arthroplasty with Extensive Bone Loss: A Retrospective Case-Series Study

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