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Knee arthrodesis with circular external fixation.

M J Garberina1, R D Fitch, E D Hoffmann

  • 1Duke University Medical Center, Department of Surgery, Durham, NC 27710, USA.

Clinical Orthopaedics and Related Research
|January 12, 2001
PubMed
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Circular external fixation achieved knee arthrodesis in 68% of patients, offering a viable limb salvage option when intramedullary nailing is contraindicated due to infection or other complications. This method provides successful fusion for select patients.

Area of Science:

  • Orthopedic surgery
  • Biomedical engineering

Background:

  • Knee arthrodesis is crucial for limb salvage in cases of severe knee disability.
  • Intramedullary nailing offers high fusion rates but is contraindicated in active infections.
  • Alternative fixation methods are needed for patients unsuitable for intramedullary nailing.

Purpose of the Study:

  • To evaluate the efficacy of circular external fixation for knee arthrodesis.
  • To assess fusion rates and functional outcomes in patients undergoing this procedure.
  • To identify complications associated with circular external fixation for knee fusion.

Main Methods:

  • Retrospective study of 19 patients undergoing knee arthrodesis with circular external fixation.
  • Radiographic evaluation for bony fusion (trabecular bridging).

Related Experiment Videos

  • Functional assessment using the Knee Society clinical rating system.

    • Main Results:

    • Successful bony fusion was achieved in 13 of 19 patients (68%).
    • Average time to fusion was approximately 4.5 months.
    • High complication rate (84%), with superficial pin tract infection (55%) and nonunion (32%) being most common.
    • No successfully fused patient reported being housebound, though most required assistive devices for ambulation.

    Conclusions:

    • Circular external fixation is an effective method for achieving knee arthrodesis in patients with contraindications to intramedullary nailing.
    • While effective, this technique is associated with a high complication rate.
    • It provides a functional limb salvage option for complex knee conditions.