Floating Knee Arthrodesis After Prosthetic Knee Infection: A Report of 48 Cases.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 9. J Arthroplasty. 2021 Aug;36(8):2896-2906. doi: 10.1016/j.arth.2021.03.009. Epub 2021 Mar 9. Knee Joint Bone Defects: Reconstruction With Bone Transport and Arthrodesis. Solomin LN(1), Shchepkina EA(1), Korchagin KL(1), Buksbaum JR(2), Sheridan GA(2), Rozbruch SR(2). Author information: (1)Vreden Russian Research Institute of Traumatology and Orthopedics, Ministry of Health of Russia, St. Petersburg, Russia. (2)Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York. BACKGROUND: The increasing in primary total knee arthroplasty has led to an increase in infectious complications, revision surgery, and bone loss. Knee joint bone defects (KJBD) may be managed using bone transport and arthrodesis with Ilizarov or bone transport over nail (BTON) techniques. The aim of this study is to compare both techniques in the reconstruction of KJBDs. METHODS: This was a retrospective cohort study of 29 patients with extensive KJBD. All patients underwent reconstruction of the KJBD using bone transport (either Ilizarov or BTON techniques). The primary outcome variables for comparison between the two groups included time in frame (days), external fixation index (EFI, days/cm), residual limb length discrepancy (cm), and complications (Caton classification). RESULTS: Gender and age profiles were comparable. Mean time spent in frame for bone transport was 566 days (σ = 236, 95% CI 429-702) for the Ilizarov cohort and 191 days (σ = 162, 95% CI 101-280) for BTON (P < .0001). EFI for the period of bone transport was 75.1 d/cm (σ = 41.5, 95% CI 51.1- 99.1) for the Ilizarov cohort and 24.7 d/cm (σ = 24.0, 95% CI 11.4-38) for BTON (P = .0004). Union, limb length discrepancy and complication rates were comparable between both groups. CONCLUSION: For the management of KJBD after failed total knee arthroplasty, BTON is preferred due to significantly less time spent in frame, lower EFI, and higher rates of normal mechanical alignment. The Ilizarov method may be useful when there is a contraindication to BTON. Copyright © 2021 Elsevier Inc. All rights reserved. DOI: 10.1016/j.arth.2021.03.009