Soft-tissue procedures for the exposed knee arthroplasty: 18 cases followed for 7 (1–17) years

Siim, Elsebeth; Jakobsen, Isa Elizabeth; Medgyesi, Sandor

doi:10.3109/17453679108994459

Cited by 12 publications

(12 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…17 It is higher after open fractures, ranging from 0 to 87%, depending on several factors. 1,18 After knee total arthroplasty, some wound healing complication may occur in up to 22% of the cases 2,3 , with infection rates ranging from 0.8 to 12.4% 19 , and, in our environment, from 0 to 6.0%. 20 Achieving good results in the treatment of seriously infected knee injuries is directly proportional to the quality and effectiveness of surgical debridement.…”

Section: Discussionmentioning

confidence: 99%

“…The rates of infection after knee osteosynthesis are quite variable, because they depend on countless factors, such as presence of bone exposure, trauma energy, degree of contamination, time to surgery, associated comorbidities, etc. 1 While after knee total arthroplasty (KTA), wound healing problems may occur in up to 22% of the cases 2,3 , with deep infection ranging from 1 to 12%. 4,5 A careful study of patients with such severe injuries is warranted.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Emprego do músculo gastrocnêmio no tratamento das lesões infectadas do joelho

et al. 2009

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Emprego do músculo gastrocnêmio no tratamento das lesões infectadas do joelho

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Erhaltungsversuche unter diesem Therapieregime mit einem Wundverschluss durch Sekundärnähte oder Hauttransplantation sind jedoch selten erfolgreich [5,14,28]. Eine Entfernung des einliegenden Metalls wurde daher traditionell empfohlen [38,44,50].Mit der Einführung moderner plastisch-chirurgischer Techniken mit Transfer von gut vaskularisiertem Weichteilgewebe [2, 10,15,17,18,28,32,33, 34,44,48,49,54,55] stiegen die Erfolge einer stabilen Deckung ohne zwingende Metallentfernung [11, 28]. Die Indikationen zum Metallerhalt wurden dementsprechend großzügiger gestellt.…”

unclassified

“…eine plastisch-rekonstruktive Intervention erfordert. In der Literatur wird am häufigsten von exponierten Knieendoprothesen [1,5,6,7,9,11,12,17,18,20,22,26,28,31,33,36,38,39,42,45,46,49] und deutlich seltener von exponierten Hüftendoprothesen [14,23,52,54] berichtet. Im Bezug auf exponierte Osteosynthesen sind die untere Extremität und die Wirbelsäule nach Trauma oder orthopädischen Korrektureingriffen die am häufigsten erwähnten Lokalisationen [13,51].…”

unclassified

See 1 more Smart Citation

Weichteildefekt und exponiertes Osteosynthesematerial — Metallerhalt oder Entfernung?

Baumeister

Levin

Erdmann

2006

Chirurg

View full text Add to dashboard Cite

Hardware used in spine surgery is commonly left in situ until bony consolidation has been achieved. The indications for hardware removal depend on length of exposure or infection, implant failure, and location. Osteosynthetic devices in the extremities may be removed and replaced by external fixators or immobilisation. Removal of prostheses requires complex second-stage reimplantation or arthrodesis. A treatment algorithm is suggested that might ease the decision whether exposed hardware can remain or requires removal before reconstruction of soft-tissue defects.

show abstract

Die Deckung ausgedehnter Weichteildefekte bei infizierten Knieendoprothesen durch Gastrocnemiuslappen

Fansa

Plogmeier

Schenk

et al. 1998

Chirurg

View full text Add to dashboard Cite

Total knee arthroplasty has become a routine procedure in surgery. Deep infections have an incidence of 2-5%. Major risk factors are large prostheses, rheumatoid arthritis, diabetes mellitus and postoperative wound-healing complications. In large soft-tissue defects with skin necrosis, local wound care shows poor results, especially if loosening of the prosthesis and necrosis of the patellar ligament are evident. In these cases, no standard surgical therapy has been developed yet. Thus, we consider meticulous débridement with synovialectomy to be mandatory. Exchange of the prosthesis may be necessary. Soft-tissue coverage ought to be performed with a gastrocnemius muscle flap covered with a split-thickness skin graft. In the last three years, 11 patients with large soft-tissue defects and necrosis of the ligament were treated according to this concept. In all cases the muscle flap healed primarily and soft tissue coverage was excellent. Two patients who underwent single-stage removal and reimplantation of the prosthesis showed reinfections of the prosthesis. Reconstruction of the ligament was performed with the flap tendon. The patients with two-stage removal and reimplantation of the prosthesis and those who retained their implants had a good functional outcome. The gastrocnemius muscle flap provides easy and reliable soft-tissue reconstruction in large defects. In our patients a two-stage operation for reimplantation of the prosthesis was superior to a single-stage procedure. The reconstructed ligament should be reinforced with autologous material to prevent a secondary rupture. Early reconstruction with sufficient soft-tissue coverage and reconstruction of the ligament offers the patient the best chances of obtaining a good functional result and prevents arthrodesis or amputation. In addition, reconstructive surgery reduces the length of hospital stay and costs.

show abstract

Soft-tissue procedures for the exposed knee arthroplasty: 18 cases followed for 7 (1–17) years

Cited by 12 publications

References 7 publications

Emprego do músculo gastrocnêmio no tratamento das lesões infectadas do joelho

Emprego do músculo gastrocnêmio no tratamento das lesões infectadas do joelho

Weichteildefekt und exponiertes Osteosynthesematerial — Metallerhalt oder Entfernung?

Die Deckung ausgedehnter Weichteildefekte bei infizierten Knieendoprothesen durch Gastrocnemiuslappen

Contact Info

Product

Resources

About