Knee Arthrodesis in the Treatment of Failed Total Knee Replacement

Vlasak, Richard; Gearen, Peter F.; Petty, William

doi:10.1097/00003086-199512000-00021

Cited by 36 publications

(57 citation statements)

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“…Articular tuberculosis, sepsis, and poliomyelitis-induced instability were the primary indications for knee arthrodesis in the late 1800s and early 1900s; the most common indication today is failed, unsalvageable TKA [7,45]. The introduction of effective adjuvant treatments for bone Fig.…”

Section: Discussionmentioning

confidence: 99%

“…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%

“…The earliest biologic arthrodeses were performed using external fixation systems, intramedullary devices, and hybrid methods with union rates from 38% to 100% and different complications [1,13,17,19,22,24,32,33,36,45,48]. Vascularized fibulae have been used to augment arthrodesis reconstructions of all types with overall excellent results [29,31,37,46].…”

mentioning

confidence: 99%

“…Although success rates of 80% to 100% have been reported after primary, biologic arthrodesis in patients without prior TKA [9,14,19,30,31,37,44], the success rate of arthrodesis performed in patients with an infection at the site of a TKA has been reported to be much lower [8]. However better results in terms of complication rates have been reported using metal implants than biologic reconstruction [2,8,9,11,13,23,33,42,45,47].Whereas Gosheger et al reported no infections in three arthrodeses with the MUTARS 1 implant [16] and Bartlett et al reported one infection in 10 Stanmore implants [3], there were nine infections in our 31 patients. This finding might be because the mean followup for our series was substantially longer at 9.5 years compared with the other series and of our infections were late infections.…”

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: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 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

View full text Add to dashboard Cite

show abstract

“…Plating is less popular, as the suboptimal soft tissues of the multiply operated knee may compromise coverage of bulky hardware [14,15]. Intramedullary devices have become increasingly popular, yet there are few large series in the literature reporting results for this technique exclusively in the management of failed TKR due to sepsis [16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%