Background: Knee arthrodesis is a rescue procedure for patients with knee periprosthetic joint infection who are not candidates for a revision surgery. The actual methods present a high complication rate with only moderate efectivity.
Methods: We retrospectively analyzed 17 cases, of patients with knee periprosthetic joint infection and bone loss treated by intramedular expandable nail and monoplanar external fixator with a mínimum evolution of 1 year, evaluating the medical records and digitalized X-rays by 2 sub specialized doctors in osteoarticular rescue surgery.
Results: From the 17 patients, 88.2% were classified as Anderson Orthopaedic Research Institute classification grade (III) and the 11.2% IIB. We obtained fusion in 82.5%, staged Hammer (I-II) in a mean time of 6.33 months. Achieving independent gait was reported in 88.2%. Our complication rate was 47.1%, most of them minor complications except for a supracondylar amputation. Our infection recurrence rate was 35.4%. Mean intervention rate was 2.47 surgeries, all without any operative room complication.
Conclusions: We achieved a fusion rate similar to other available knee arthrodesis methods in a similar treatment time; with lower complication rate, making it a suitable rescue alternative for knee arthrodesis in patients with significant bone loss and knee periprosthetic joint infection.
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J Foot Ankle Surg
January 2025
Surgical Fellow, Florida Orthopedic Foot & Ankle Center Fellowship, 5741 Bee Ridge Rd #490, Sarasota, FL 34233. Electronic address:
Metal allergies in surgery are often underreported and under diagnosed. Oftentimes, the symptoms of metal allergy closely resemble those of infection and the protocol is removal of the offending implant. Identification of metal allergies in the preoperative workup is imperative to provide the best patient care and outcomes.
View Article and Find Full Text PDFJ Orthop Case Rep
December 2024
Department of Orthopaedics, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.
Introduction: After the spine, the knee is the second most common location for skeletal tuberculosis. An unusual complication of tuberculosis infection is triple knee deformity. The combination of knee flexion, posterolateral tibial subluxation, and external tibial rotation over femoral condyles manifests as a severe deformity.
View Article and Find Full Text PDFJ Arthroplasty
December 2024
Hospital Universitari i Politècnic la Fe, Av Fernando Abril Martorell 106, 46015, Valencia, SPAIN.
Background: Knee arthrodesis is a means of avoiding above-knee amputation after a periprosthetic joint infection (PJI). The objective of this study was to analyze the results of floating knee arthrodesis in patients who had a history of a periprosthetic knee infection and to perform an external validation of the BAOR Scale (Baeza-Ortega scale). The analysis consisted of determining reinfection rates, functional results, and the survival of arthrodesis.
View Article and Find Full Text PDFJ Knee Surg
December 2024
Arthroplasty, New England Baptist Hospital, Boston, United States.
Debridement with antibiotics and implant retention (DAIR) is commonly utilized for prosthetic joint infection (PJI) for total knee arthroplasty (TKA); particularly in cases of acute PJI 1. Reported success rates of DAIR have been highly variable, but the overall success rate of DAIR cohort studies is ~70-80% 2. However, no large database studies have investigated the success rate of DAIR.
View Article and Find Full Text PDFBMC Musculoskelet Disord
November 2024
Center for Sports Medicine, Southwest Hospital, Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400036, China.
Purpose: The conversion of knee arthrodesis to total knee arthroplasty (TKA) is a challenging procedure. This article aims to report a case of fusion knee with patellar absence who was converted to TKA and has achieved good results.
Methods: The patient, a 23 years old Tibetan Buddhist monk, sustained a left knee joint injury at the age of 12 due to a car accident, leading to subsequent knee arthrodesis at 18 years old as a result of recurrent severe infections.
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