Arthrodesis of the knee
Janet D Conway1, Michael A Mont, Hari P Bezwada
1Rubin Institute for Advanced Orthopaedics, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA. jconway@lifebridgehealth.org
The Journal of Bone and Joint Surgery. American Volume
|April 8, 2004
Summary
Knee arthrodesis, a surgical fusion, is often needed after total knee replacement infections. It offers a stable, functional limb, outperforming amputation, but conversion back to a knee replacement is complex.
Area of Science:
- Orthopedic Surgery
- Infectious Disease
- Biomedical Engineering
Background:
- Infection following total knee arthroplasty (TKA) is a primary indication for knee arthrodesis.
- Bone stock deficiencies and poor bone apposition negatively impact arthrodesis success.
- Knee arthrodesis aims to salvage the limb and restore function in challenging cases.
Purpose of the Study:
- To evaluate the outcomes and functional status of patients undergoing knee arthrodesis.
- To compare the functional results of knee arthrodesis with above-the-knee amputation.
- To assess the risks associated with converting a solid knee fusion back to a TKA.
Main Methods:
- Review of clinical outcomes for patients who underwent knee arthrodesis.
- Comparative analysis of functional scores between knee arthrodesis and amputation.
- Evaluation of complication rates for revision TKA following knee fusion.
Main Results:
- Knee arthrodesis can yield a stable and painless extremity for active patients.
- Functional outcomes post-knee arthrodesis are superior to those after above-the-knee amputation.
- Conversion of a fused knee to a TKA carries a significant risk of complications.
Conclusions:
- Knee arthrodesis is a viable option for limb salvage in infected TKAs, providing good function.
- Arthrodesis offers a better functional prognosis than amputation for suitable candidates.
- Revision of knee arthrodesis to TKA should be approached with caution due to high complication rates.
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