[Mixed knee arthrodesis a rescue alternative in knee periprosthetic joint infection]

Knee arthrodesis is a rescue procedure for patients with knee periprosthetic joint infection who are not candidates for a revision surgery. The actual methods present a high complication rate with only moderate efectivity.

We retrospectively analyzed 17 cases, of patients with knee periprosthetic joint infection and bone loss treated by intramedular expandable nail and monoplanar external fixator with a mínimum evolution of 1 year, evaluating the medical records and digitalized X-rays by 2 sub specialized doctors in osteoarticular rescue surgery.

From the 17 patients, 88.2% were classified as Anderson Orthopaedic Research Institute classification grade (III) and the 11.2% IIB. We obtained fusion in 82.5%, staged Hammer (I-II) in a mean time of 6.33 months. Achieving independent gait was reported in 88.2%. Our complication rate was 47.1%, most of them minor complications except for a supracondylar amputation. Our infection recurrence rate was 35.4%. Mean intervention rate was 2.47 surgeries, all without any operative room complication.

We achieved a fusion rate similar to other available knee arthrodesis methods in a similar treatment time; with lower complication rate, making it a suitable rescue alternative for knee arthrodesis in patients with significant bone loss and knee periprosthetic joint infection.