Total knee arthroplasty after formal knee fusion using unconstrained and semiconstrained components

Henkel, Thomas R.; Boldt, J.; Drobny, T.; Munzinger, U.

doi:10.1054/arth.2001.24375

Cited by 31 publications

(28 citation statements)

References 5 publications

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“…The preferred incision was a medial parapatellar approach, when useable prior incisions are present, the most lateral one was chosen in order to minimise the revascularisation of the lateral skin [3][4][5]. If the patella was fused to the femoral condyles, an osteotomy was performed to mobilise the patella from its femoral attachment without damaging the extensor mechanism [3,5,7]. In order to achieve adequate surgical exposure, a tibial tubercle osteotomy was performed; refixation was done with two to three screws [3-5, 7, 12].…”

Section: Surgical Techniquementioning

confidence: 99%

“…Conversion of the AD to a total knee arthroplasty (TKA) is an option for patients with AD. The conversion of a fused knee to a TKA is not only a challenging surgical procedure [3] but it is also associated with a high incidence of complications [2,[4][5][6][7]. Sufficient soft tissue and an intact extensor mechanism are important factors in achieving good clinical results of a conversion.…”

Section: Introductionmentioning

confidence: 99%

“…Sufficient soft tissue and an intact extensor mechanism are important factors in achieving good clinical results of a conversion. Therefore, conversion should be evaluated on a case-by-case basis [7,8]. It is important that patients are highly motivated and have realistic expectations about the procedure, risk of complications and postoperative results in order to be successful [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, conversion should be evaluated on a case-by-case basis [7,8]. It is important that patients are highly motivated and have realistic expectations about the procedure, risk of complications and postoperative results in order to be successful [7][8][9]. Judgment of patients generally has been positive and satisfied after conversion, even after a complicated postoperative course or outcome [3,7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors advocate the procedure [5,6,[9][10][11], while others have expressed concern over its efficacy in the presence of the high complication rate [1,2,7,12]. Thus, a systematic review and meta-analyses of the current literature was done, to examine the role of TKA after AD of the knee and assess the clinical outcome, complications, surgical technique, patientrelated outcome measures and methodological quality.…”

Section: Introductionmentioning

confidence: 99%

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Conversion from knee arthrodesis to arthroplasty: systematic review

Kernkamp

Verra

Pijls

et al. 2016

International Orthopaedics (SICOT)

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Purpose Arthrodesis (AD) of the knee reduces pain and provides stability, but has severe functional and social limitations. There has been ample discussion on the value of a conversion of an AD to a total knee arthroplasty (TKA). The aim of this study was to perform a review and meta-analysis of the current literature on conversion of an AD to TKA and assess clinical outcome, complication rate, surgical technique and overall patient-related outcome measures. Methods PubMed, Embase, Web of Science, Cochrane, CENTRAL, CINAHL, Academic Search Premier, ScienceDirect and searching by hand for papers on conversion of AD of the knee to TKA. Two reviewers independently reviewed all titles and abstracts, and extracted the available data. Study eligibility criteria were: conversion of knee AD to TKA, five cases or more and non-oncology patients. Data consisted of study characteristics, patient demographics, clinical outcome and complications. Additionally, details on surgical technique were reviewed. Results Of the 866 unique references identified, six papers were included for further analyses, comprising a total of 123 knees with conversion of AD of the knee to TKA. Mean gain of knee flexion was 80 degrees and the mean HSS score improved with 20 points. A complicated postoperative course was found in 65 % of all cases. The most frequent complication was skin necrosis (25 %), followed by arthrofibrosis (13 %), infection (11 %) and revision (11 %). Major complications such as refusion, amputation and death occurred in less than 5 % of all cases. Discussion The majority of the papers consisted of small case series of moderate methodological quality, resulting in 123 included knees. Further series are necessary to draw definitive conclusions. Conclusions This is the first systematic review and metaanalysis on conversion of a knee arthrodesis to TKA. Good clinical results can be expected after conversion, albeit at a high risk of postoperative complications.

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