Septic single-stage knee arthrodesis after failed total knee arthroplasty using a cemented coupled nail

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management
• Limb Salvage Procedures

Background:

• Infected total knee arthroplasty (TKA) poses significant challenges, often necessitating salvage procedures for limb preservation.
• Extensor mechanism deficiency complicates treatment following failed TKA due to infection.

Purpose of the Study:

• To evaluate the outcomes of single-stage knee arthrodesis using an intramedullary cemented coupled nail in patients with failed and infected TKA.
• To assess the efficacy and patient satisfaction with this salvage procedure.

Main Methods:

• Retrospective study of 27 patients (2002-2012) undergoing single-stage knee arthrodesis for infected TKA.
• Intramedullary cemented coupled nail without bone-on-bone fusion was used.
• Follow-up included Visual Analogue Scale (VAS) and Short Form (SF)-36 for subjective evaluation.

Main Results:

• Mean follow-up was 67.1 months.
• Mean VAS score was 1.44, indicating low pain levels.
• Recurrent infection occurred in 14.8% of patients; one patient required amputation.
• All patients, including the one with amputation, would opt for arthrodesis again.

Conclusions:

• Single-stage knee arthrodesis with an intramedullary nail is an acceptable and effective salvage procedure for limb preservation after infected TKA failure.
• The technique provides satisfactory pain relief and functional outcomes, with high patient willingness to repeat the procedure.