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Arthrodesis in failed total knee replacement

W F Hagemann, G W Woods, H S Tullos

    The Journal of Bone and Joint Surgery. American Volume
    |September 1, 1978
    PubMed
    Summary
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    Compression arthrodesis is a salvage option for failed knee replacements. Technical errors in fixation and bone contact are key reasons for fusion failure, though double clamps may improve outcomes.

    Area of Science:

    • Orthopedic Surgery
    • Biomedical Engineering

    Background:

    • Total knee replacement (TKR) can fail, necessitating salvage procedures.
    • Compression arthrodesis is one such salvage technique for failed TKR.

    Purpose of the Study:

    • To evaluate the efficacy of compression arthrodesis as a salvage procedure for failed TKR.
    • To identify factors contributing to fusion failure in compression arthrodesis.

    Main Methods:

    • Retrospective analysis of fourteen patients undergoing compression arthrodesis for failed TKR.
    • Assessment of technical adequacy, fixation methods (single vs. double clamp), and bone-to-bone contact.

    Main Results:

    • Five out of fourteen patients experienced fusion failure.

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  • Technical inadequacy, specifically poor fixation and bone contact, was the primary cause of failure.
  • Seven of nine technically adequate procedures achieved fusion, with an average delay of 5.3 months.
  • Double clamp fixation appeared more effective than single clamp fixation.

    • Conclusions:

    • Compression arthrodesis can be a viable salvage procedure for failed TKR when technically sound.
    • Meticulous surgical technique, ensuring stable fixation and bone apposition, is crucial for successful fusion.
    • Further investigation into optimal fixation methods, such as double clamping, may enhance fusion rates.