Knee Arthrodesis With Computer-Assisted External Fixator System After Prosthetic Joint Infection for Elderly Population

Abstract

Introduction: This study aimed to evaluate the effectiveness of a computer-assisted circular external fixator used to achieve arthrodesis in elderly patients with failed infected total knee arthroplasty. Materials and Methods: Retrospectively 11 patients who treated with arthrodesis between 2015 and 2020 were included in the study. The average age was 73.5 ±4.73 years (65–81). All patients had recurrent infections after total knee arthroplasty. Radiologic evaluations, the time for fusion, shortening of extremities, visual analog scale scores, Oxford knee scoring system, lower extremity functional scale of all patients were compared pre-and post-operatively. complications of the technique were noted. Results: The mean follow-up was 33.7 ±12.85 (12–52) months. Fusion was achieved in all patients. The average limb length discrepancy after removal of the fixator was 46±0.78 (36–61) mm. The mean visual analog scale score measured pre-op was 6.91±0.94 (5–8), and after fixator removal they were measured as 2.36±0.92 (1–4). The mean Oxford knee score was 10.27±2.68 (4–14) pre-operatively and 28.64±2.69 (23–32) postoperatively. The mean, lower extremity functional scale was 17.06±9.38 (7.5–33.8) pre-operatively and 38.54±12.22 (21.3–56.3) postoperatively. No joint infection recurrence was seen post-operatively. Conclusion: Arthrodesis is a suitable option for elderly patients with limited mobilization who are tired of repeated revision surgeries. Due to its high fusion and low complication rate, computer-assisted circular external fixator is an effective method in the treatment of difficult knee arthrodesis required after infected total knee arthroplasty. Key Words: Arthroplasty, Replacement, Knee; Reoperation; Infection; Arthrodesis; External Fixators.