Knee arthrodesis—A review

Somayaji, H.S.; Tsaggerides, P.; Ware, Howard; Dowd, G.S.E.

doi:10.1016/j.knee.2008.03.005

Cited by 68 publications

(97 citation statements)

References 42 publications

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“…The failure rate of these devices is much higher than for conventional total joint arthroplasty; therefore, managing their failures has created a new indication for segmental arthrodesis [18,49]. The biomechanical demands on these arthrodeses are substantial and consequently the reported failure rates are high [2,5,9,20,44,45,49]. We report the results of segmental arthrodesis with a modular, metallic implant system.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the most common indications for knee arthrodesis are chronic infection after arthroplasty and tumors requiring extensive resection of the bony and soft tissues about the knee, rendering the joint with inadequate soft tissue coverage and extensor mechanism loss [39]. In appropriate patients, arthrodesis provides pain relief, stability, and improved mobility [44]. Contraindications for knee arthrodesis include contralateral knee amputation and ipsilateral hip arthrodesis [44].…”

Section: Introductionmentioning

confidence: 99%

“…In appropriate patients, arthrodesis provides pain relief, stability, and improved mobility [44]. Contraindications for knee arthrodesis include contralateral knee amputation and ipsilateral hip arthrodesis [44]. Many techniques for knee arthrodesis have been described, including the Charnley compression arthrodesis technique, Putti-Juvara technique, xenograft, external fixation, intramedullary nail with bone graft, intramedullary nail and cement, and segmental allograft [5-7, 12, 14, 21, 27, 28, 30, 35, 40].…”

Section: Introductionmentioning

confidence: 99%

“…To provide improved and more uniform outcomes, modular prosthetic arthrodesis systems were developed [3,16,48]. This type of system provides inherent advantages over conventional methods including immediate fixation and weightbearing and modularity allowing for segmental deficit reconstruction [44].…”

Section: Introductionmentioning

confidence: 99%

“…Autograft, in the form of femoral and fibular strut grafts, was the earliest use of interposition materials [21,24,35]. Structural bulk allografts also have been used; however, the union rate is generally lower than those for autograft and failures from infection and fracture are higher [4,10,25,44]. Allograft composites have shown some promise in the medium term, but longer-term followup is required [44].…”

mentioning

confidence: 99%

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Is There a Role for Knee Arthrodesis With Modular Endoprostheses for Tumor and Revision of Failed Endoprostheses?

Angelini

Henderson

Trovarelli

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Knee arthrodeses are performed to treat infection after arthroplasty and tumors requiring extensive soft tissue resection. Many techniques have been described, but most have important disadvantages. Currently, endoprosthetic arthrodesis implants are available, but little is known about them. Questions/purposes Our objective was to analyze a series of knee arthrodeses with a modular prosthetic system to evaluate (1) survivorship of the implant, (2) complications, (3) whether survivorship differed between arthrodeses done for primary tumor resection and revision reconstructions, and (4) whether survivorship differed based on the presence of previous infection or the use of a gastrocnemius flap. Methods We present 32 patients with modular knee arthrodeses; arthrodeses were performed in 25 patients with tumors and in seven patients without tumors. There were 14 implants done at the time of tumor resection and 18 for revision of failed implants. Survivorship and complications were analyzed with Kaplan-Meier curves. Log-rank test was used for comparison between primary and revision implants, not infected and previously infected implants, and use or nonuse of a gastrocnemius flap.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Is There a Role for Knee Arthrodesis With Modular Endoprostheses for Tumor and Revision of Failed Endoprostheses?

Angelini

Henderson

Trovarelli

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Selecting a high‐dose antibiotic‐laden cement knee spacer

Hollyer

Ivanov

Kappagoda³

et al. 2023

Journal Orthopaedic Research

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Prosthetic joint infection [PJI] after total knee arthroplasty (TKA) remains a common and challenging problem for joint replacement surgeons and patients. Once the diagnosis of PJI has been made, patient goals and characteristics as well as the infection timeline dictate treatment. Most commonly, this involves a two‐stage procedure with the removal of all implants, debridement, and placement of a static or dynamic antibiotic spacer. Static spacers are commonly indicated for older, less healthy patients that would benefit from soft tissue rest after initial debridement. Mobile spacers are typically used in younger, healthier patients to improve quality of life and reduce soft‐tissue contractures during antibiotic spacer treatment. Spacers are highly customizable with regard to antibiotic choice, cement variety, and spacer design, each with reported advantages, drawbacks, and indications that will be covered in this article. While no spacer is superior to any other, the modern arthroplasty surgeon must be familiar with the available modalities to optimize treatment for each patient. Here we propose a treatment algorithm to assist surgeons in deciding on treatment for PJI after TKA.

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Knee joint transplantation combined with surgical angiogenesis in rabbits—A new experimental model

et al. 2011

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Summary Purpose We have previously described a means to maintain bone allotransplant viability, without long-term immune modulation, replacing allogenic bone vasculature with autogenous vessels. A rabbit model for whole knee joint transplantation was developed and tested using the same methodology, initially as an autotransplant. Materials/Methods Eight New Zealand White rabbit knee joints were elevated on a popliteal vessel pedicle to evaluate limb viability in a non-survival study. Ten additional joints were elevated and replaced orthotopically in a fashion identical to allotransplantation, obviating only microsurgical repairs and immunosuppression. A superficial inferior epigastric facial (SIEF) flap and a saphenous arteriovenous (AV) bundle were introduced into the femur and tibia respectively, generating a neoangiogenic bone circulation. In allogenic transplantation, this step maintains viability after cessation of immunosuppression. Sixteen weeks later, x-rays, microangiography, histology, histomorphometry and biomechanical analysis were performed. Results Limb viability was preserved in the initial 8 animals. Both soft tissue and bone healing occurred in 10 orthotopic transplants. Surgical angiogenesis from the SIEF flap and AV bundle was always present. Bone and joint viability was maintained, with demonstrable new bone formation. Bone strength was less than the opposite side. Arthrosis and joint contractures were frequent. Conclusion We have developed a rabbit knee joint model and evaluation methods suitable for subsequent studies of whole joint allotransplantation.

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Knee arthrodesis—A review

Cited by 68 publications

References 42 publications

Is There a Role for Knee Arthrodesis With Modular Endoprostheses for Tumor and Revision of Failed Endoprostheses?

Is There a Role for Knee Arthrodesis With Modular Endoprostheses for Tumor and Revision of Failed Endoprostheses?

Selecting a high‐dose antibiotic‐laden cement knee spacer

Knee joint transplantation combined with surgical angiogenesis in rabbits—A new experimental model

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