Modulares Kniearthrodesesystem TITAN (KAM-TITAN) nach fehlgeschlagener Knieendoprothetik

Gathen, Martin; Schmolders, Jan; Wimmer, Matthias; Gravius, Nadine; Randau, Thomas M.; Gravius, Sascha; Friedrich, M

doi:10.1007/s00064-019-0605-9

Cited by 8 publications

(5 citation statements)

References 30 publications

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“…Knee Score range 38-39.2 and WOMAC score was 55.8 [20][21][22]. The functional outcomes and subjective measurements of pain in our patient group are comparable to these results.…”

Section: Discussionsupporting

confidence: 82%

Straight versus modular nail: Analysis of mechanical properties two knee arthrodesis methods.

Białecki¹,

Para²,

Sobolewski³

et al. 2020

Preprint

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Background Complications after arthroplasty often result in irreversible disability. In some cases for the extremity to be salvaged, the permanent knee joint arthrodesis is the last-chance procedure. Modular implant design simplifies surgical technique but modularity may potentially compromise mechanical strength of an implant. Mechanical properties of the implant are particularly important in case of knee arthrodesis without bone-on-bone contact where forces during gait and weight bearing are transmitted directly through the nail. The aim of this article was to perform comparative analysis of the mechanical properties of modular nail CHARFIX2 FN, when compared to the femoral nail, used for knee arthrodesis; and to analyze the effectiveness of treatment with use of this nail based on the observations of clinical cases. Methods Comparative analysis of: the static 4-point bending test, dynamic 4-point bending test and static torsion test. All tests were performed in accordance with requirements of ASTM F 1264. A clinical analysis of 5 cases, in which CHARFIX2 FN nails were used, was also performed. Results Based on the results of mechanical tests, the strength characteristics of CHARFIX2 FN nail have been found superior and more advantageous than corresponding features of the standard femoral nail. For CHARFIX2 FN nail, the median for flexural stiffness was almost 4 times higher and for maximum torque value was almost 2 times higher when compared to the femoral nail. Observations of the clinical cases gave satisfactory results. Conclusions The obtained mechanical tests present significant differences between CHARFIX2 FN and the femoral nail in mechanical strength and, therefore, its improved stability and safety for patients during walking. It can be used for permanent knee immobilization with satisfactory clinical results. The functional outcomes and subjective measurements of pain in patients treated with CHARFIX2 FN group are satisfying.

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“…Knee Score range 38-39.2 and WOMAC score was 55.8 [20][21][22]. The functional outcomes and subjective measurements of pain in our patient group are comparable to these results.…”

Section: Discussionsupporting

confidence: 82%

Straight versus modular nail: Analysis of mechanical properties two knee arthrodesis methods.

Białecki¹,

Para²,

Sobolewski³

et al. 2020

Preprint

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“…Since knee arthrodesis is considered a salvage method due to the loss of range of motion, some items in this questionnaire are presumably negatively affected. Gathen et al evaluated a cohort of modular knee arthrodesis after failed revision TKA, and found a mean OKS score of 39.2 [6]. Friedrich et al had a mean OKS score of 38 in their study of two stage arthrodesis of a modular intramedullary nail after septic TKA failure [5].…”

Section: Discussionmentioning

confidence: 99%

“…The indications for knee arthrodesis are limb salvage after failed TKA revision surgery, deficient extensor mechanism and high functional demand in young patients, poor soft tissue coverage, and severe infections with highly virulent microorganisms that preclude joint reconstruction with arthroplasty implants [4]. Several techniques for knee arthrodesis have been described: external fixation, intramedullary nailing, plate fixation, and modular intramedullary implants [5][6][7][8]. Modular segmental implants allow immediate weight bearing without the need of bony fusion, and minimize leg length discrepancy (LLD).…”

Section: Introductionmentioning

confidence: 99%

Early results of a novel modular knee arthrodesis implant after uncontrolled periprosthetic knee joint infection

Büyükdoğan,

Öztürkmen,

Goker

et al. 2023

BMC Musculoskelet Disord

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Aim The aim of this study is to evaluate the functional outcomes and complications after non-fusion knee arthrodesis with a modular segmental intramedullary implant used for infected total knee arthroplasty revisions. Methods A retrospective review of the patients who had been surgically treated with a modular intramedullary arthrodesis implant for recurrent infection after revision TKA between January 2016 and February 2020 were included. The indications for arthrodesis were failed infected TKA with massive bone loss, deficient extensor mechanism and poor soft tissue coverage that precluded joint reconstruction with revision TKA implants. Clinical outcomes were assesed with visual analogue scale for pain (pVAS), Oxford knee score (OKS) and 12-item short form survey (SF-12). Full-length radiographs were used to verify limb length discrepancies (LLD). Results Fourteen patients (4 male and 10 female) patients with a mean age of 69.3 (range, 59 to 81) years at time of surgery were available for final follow-up at a mean of 28.8 months (range, 24–35 months). All clinical outcome scores improved at the final follow-up (pVAS, 8.5 to 2.6, p = .01; OKS, 12.6 to 33.8, p = .02; SF-12 physical, 22.9 to 32.1, p = .01 and SF-12 mental, 27.7 to 40.2, p = .01). The mean LLD was 1.0 cm (range, + 15 – 2.3 cm). Re-infection was detected in three patients (21.4%). Two patients were managed with suppressive antibiotic treatment and a third patient required repeat 2-stage revision procedure. In one patient, a periprosthetic femur fracture was observed and treated with plate osteosynthesis. Conclusion Uncontrolled infection after total knee arthroplasty can be effectively treated with arthrodesis using a modular intramedullary nail and satisfactory functional results can be obtained. Level of evidence Level 4, Retrospective cohort study.

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“…74 Modular IM arthrodesis nails have shown similar functional outcome, pain reduction and infection control results as biologic fixation while minimizing LLD at 30-month follow-up. 75 After a failed two-stage revision, knee arthrodesis presents the treatment most likely to yield the highest expected quality of life. 76…”

Section: Salvage Proceduresmentioning

confidence: 99%

Current Insights in the Evaluation and Treatment of Infected Total Knee Arthroplasty

Ashley

Parvızı

2021

J Knee Surg

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Total knee arthroplasty is a widely successful procedure, but a small percentage of patients have a postoperative course complicated by periprosthetic joint infection (PJI). PJI is a difficult problem to diagnose and to treat, and the management of PJI differs, depending on the acuity of the infection. This paper discusses the established and newer technologies developed for the diagnosis of PJI as well as different treatment considerations and surgical solutions currently available.

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Modulares Kniearthrodesesystem TITAN (KAM-TITAN) nach fehlgeschlagener Knieendoprothetik

Abstract: Die folgenden vier Originalarbeiten liegen der kumulativen Habilitationsschrift zu Grunde, welche die wesentlichen Ergebnisse der Publikationen zusammenfasst und diskutiert.

Cited by 8 publications

References 30 publications

Straight versus modular nail: Analysis of mechanical properties two knee arthrodesis methods.

Straight versus modular nail: Analysis of mechanical properties two knee arthrodesis methods.

Early results of a novel modular knee arthrodesis implant after uncontrolled periprosthetic knee joint infection

Current Insights in the Evaluation and Treatment of Infected Total Knee Arthroplasty

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