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Soft Tissue Procedures in the Multiply Operated on Knee Replacement Patient
Gerard A Sheridan1, Peter A Lennox2, Bassam A Masri1
1Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.
The Orthopedic Clinics of North America
|June 20, 2022
Summary
For multiply operated knee replacements, muscle flaps are a reliable soft tissue procedure. Negative pressure wound therapy shows promise, but further research is needed for definitive conclusions.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Wound Healing
Background:
- Managing soft tissue defects after multiple knee replacement surgeries presents significant challenges.
- Existing soft tissue procedures lack a clear superiority, necessitating a review of current and emerging techniques.
Purpose of the Study:
- To evaluate the effectiveness of various soft tissue procedures for multiply operated knee replacements.
- To identify optimal strategies for managing complex knee wounds in revision arthroplasty.
Main Methods:
- Literature review focusing on muscle flaps and negative pressure wound therapy for knee salvage.
- Analysis of existing studies on surgical outcomes and complication rates.
Main Results:
- Muscle flaps represent the most extensively documented and currently utilized workhorse technique.
- Closed incision negative pressure wound therapy shows potential but requires further large-scale validation.
- No single soft tissue procedure demonstrates overwhelming superiority.
Conclusions:
- A combination of techniques, individualized to the patient, is the most probable best approach for multiply operated knees.
- Muscle flaps remain a cornerstone for orthopedic and plastic surgeons in knee reconstruction.
- Continued research into negative pressure wound therapy is warranted to fully understand its role.
