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Outcome after knee arthrodesis for failed septic total knee replacement using a monolateral external fixator
Pablo S Corona1, Alejandro Hernandez, M Mercedes Reverte-Vinaixa
1Department of Orthopaedic Surgery, Hospital Universitario Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.
Journal of Orthopaedic Surgery (Hong Kong)
|December 25, 2013
Summary
Knee arthrodesis with a monolateral external fixator effectively eradicates infection and achieves fusion in failed septic total knee replacements. Successful fusion leads to good pain relief and patient satisfaction.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Management
- Arthroplasty Revision
Background:
- Septic total knee replacement (TKR) failure presents complex challenges.
- Revision surgeries are often necessary, carrying significant risks and complications.
Purpose of the Study:
- To assess the efficacy of knee arthrodesis using a monolateral external fixator for failed septic TKR.
- Evaluate pain levels, patient satisfaction, fusion rates, and infection eradication.
Main Methods:
- Retrospective review of 21 patients (10 male, 11 female) aged 70-88 years undergoing knee arthrodesis.
- Patients had a mean of 3.4 prior procedures.
- Evaluated infection eradication, fusion rates, time to fusion, pain, satisfaction, and quality of life.
Main Results:
- High infection eradication rate (86%) and fusion rate (81%) were achieved.
- Fusion required a mean of 10.3 months.
- Achieving fusion correlated with significantly lower pain scores (2.3 vs. 6.4) and higher patient satisfaction (82% satisfied).
Conclusions:
- Knee arthrodesis with a monolateral external fixator is effective for managing failed septic TKR.
- The procedure yields high rates of infection eradication and fusion, with good patient outcomes when fusion is successful.
- Extended time to fusion should be considered in treatment planning.