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Rotation flaps for coverage after total knee arthroplasty
Leonardo Rafael Pozzobon1, Camilo Partezani Helito1, Tales Mollica Guimarães1
1Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Acta Ortopedica Brasileira
|January 24, 2014
Summary
Local myocutaneous rotation flaps effectively cover wounds after total knee arthroplasty, but functional outcomes depend heavily on controlling infection. Flap coverage is a viable option for prosthesis exposure.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Infectious Disease Management
Background:
- Wound dehiscence after total knee arthroplasty (TKA) presents a significant challenge.
- Infection associated with dehiscence complicates TKA outcomes.
- Myocutaneous flaps offer a reconstructive option for exposed prostheses.
Purpose of the Study:
- To evaluate the efficacy of local myocutaneous rotation flaps for treating wound dehiscence post-TKA.
- To assess functional outcomes and complication rates associated with this surgical approach.
Main Methods:
- A retrospective case series of nine patients undergoing TKA between 2000-2012.
- Flap coverage was employed for skin dehiscence with prosthesis exposure and infection.
- Medial gastrocnemius rotation flaps were used in eight cases; advancing skin flaps in one.
Main Results:
- Successful prosthesis coverage and flap viability were achieved in 89% of cases.
- Four cases allowed prosthesis retention or revision; four required amputation due to infection.
- Functional outcomes were unsatisfactory in 89% of cases, often linked to infection control failure.
Conclusions:
- Local myocutaneous rotation flaps are a viable option for covering exposed prostheses after TKA.
- Functional failure is strongly correlated with the inability to manage associated infections.
- Effective infection control is paramount for successful TKA revision and patient outcomes.
