Knee arthrodesis with a unilateral external fixator

The operative fusion of the knee joint remains a valuable technique in posttraumatic and infectious destruction of the knee. External fixation is the technique of choice. Due to the benefits of the monofixator in regard to stability, limited damage of soft tissues and high patient comfort, arthrodesis of the knee joint using an anteriorly placed unilateral external fixator is the procedure routinely used at our institution. From 1985 to 1994, 19 knee arthrodesis procedures were performed with a monofixator. Indications for operative fusion of the knee were an infectious destruction of the joint following osteosynthesis (tibial plateau) in 12 cases, posttraumatic arthrosis of the knee joint with chronic infection in 4 cases, flexion ankylosis of the knee in 1 patient, and destructive osteoarthritis of the knee complicated by an empyema in one case. In one patient, a rearthrodesis was performed for a non-union, following an arthrodesis attempt for infected knee arthroplasty. In all cases, stable fusion of the knee joint in a correct position with complete eradication of infection was obtained. Mean fixation time was 22 weeks. The fixator did not need to be removed prematurely.