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Vascularised knee joint transplantation in man: the first two years experience
M H Kirschner1, L Brauns, O Gonschorek
1Trauma Centre Murnau, Murnau/Staffelsee, Germany.
Objective:
To describe our early experience with a new technique for restoring destroyed knee joints to give reasonable functional results.
Design:
Observational clinical trial.
Setting:
Level-1-Trauma centre, Germany.
Subjects:
5 patients with large bone defects of the knee and loss of the extensor apparatus caused either by serious injury alone, or infection after serious injury.
Interventions:
Transplantation of fresh and perfused knee joints with a vascular pedicle from multiorgan donors under immunosuppression.
Main Outcome And Measures:
Ability to walk, need to remove one transplanted joint.
Results:
Four patients are able to walk, the range of movement being from 50 degrees-120 degrees. The first patient additionally had to be provided with a total knee joint arthroplasty. In the third patient the graft became infected and had to be removed. She finally had an arthrodesis and bone lengthening by the Ilizarov technique.
Conclusions:
Transplantation of the knee joint may be an alternative to bone lengthening or amputation for patients with total loss of the extensor apparatus.