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Free flap coverage for knee salvage

J C Yuen1, A T Zhou

  • 1Department of Surgery, University of Arkansas for Medical Sciences, Little Rock 72205-7199, USA.

Annals of Plastic Surgery
|August 1, 1996
PubMed
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Free flap reconstruction effectively salvages knee wounds with exposed joints or osteomyelitis. This method offers excellent functional recovery for knee injuries, minimizing the need for vein grafts.

Area of Science:

  • Orthopedic Surgery
  • Plastic Surgery
  • Microsurgery

Background:

  • Knee joint exposure and adjacent osteomyelitis present complex reconstructive challenges.
  • Unavailability of local flaps necessitates advanced soft-tissue reconstruction techniques.

Purpose of the Study:

  • To evaluate the efficacy of free flap reconstruction for severe knee wounds.
  • To assess functional outcomes and salvage rates in patients with joint exposure or osteomyelitis.

Main Methods:

  • Review of 11 consecutive cases using free flaps (10 muscle, 1 fasciocutaneous) for knee reconstruction.
  • Analysis of recipient vessel selection, including distal superficial femoral artery, anterior tibial artery, and popliteal artery.
  • Assessment of flap survival, functional recovery, and complications.

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Main Results:

  • Successful knee salvage in all cases with a single free flap, except for one requiring a second flap due to necrosis.
  • Excellent return of knee function reported in patients without pre-existing knee conditions.
  • Utilization of small recipient arteries and venae comitantes facilitated flap coverage and eliminated the need for vein grafts.

Conclusions:

  • Free flap transfer is a reliable and effective method for salvaging complex knee wounds.
  • The technique provides excellent functional outcomes and high success rates in challenging orthopedic cases.
  • Strategic selection of recipient vessels enhances reconstructive capabilities and simplifies the procedure.