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Updated: Feb 10, 2026
08:18
Engineered Vascularized Muscle Flap
Published on: January 11, 2016
8.7K
Two sequential free flaps for coverage of a total knee implant
Siew Weng Ng1, Hui Chai Fong2, Bien-Keem Tan2
1Sweng Plastic Aesthetic and Reconstructive and Surgery, Singapore, Singapore.
Archives of Plastic Surgery
|May 24, 2018
Summary
Knee revision surgery after infection is difficult due to high reinfection risks. Flap reconstruction, like using latissimus dorsi flaps, significantly improves outcomes for these complex cases.
Area of Science:
- Orthopedic surgery
- Plastic and reconstructive surgery
- Infectious disease
Background:
- Peri-prosthetic joint infection (PJI) following knee revision arthroplasty presents significant challenges.
- High risk of recurrent infection and compromised soft tissue quality complicate revision procedures.
- Flap reconstruction is a crucial technique for salvaging infected arthroplasties.
Purpose of the Study:
- To highlight the challenges and successful management of a complex knee revision arthroplasty complicated by peri-prosthetic joint infection.
- To emphasize the role of staged flap reconstruction in managing severe soft tissue defects after infected knee revision.
Main Methods:
- Presentation of a challenging clinical case involving staged reconstruction for a patient with a history of infected knee revision arthroplasty.
- Initial management included a medial gastrocnemius flap.
- Subsequent reconstruction involved two free latissimus dorsi flaps for soft tissue coverage.
Main Results:
- The staged flap reconstruction approach, utilizing both medial gastrocnemius and latissimus dorsi flaps, led to successful salvage of the infected knee arthroplasty.
- This complex, multi-stage reconstruction addressed significant soft tissue defects and infection control challenges.
Conclusions:
- Flap reconstruction should be strongly considered in all cases of infected knee revision arthroplasty.
- Staged free latissimus dorsi flap reconstruction offers a viable solution for complex soft tissue defects in challenging PJI cases.
- Successful management of infected knee revision arthroplasty relies on a multidisciplinary approach including orthopedic and reconstructive surgery.
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