Abstract
Introduction: Knee arthrodesis can be an effective treatment after an infected revision Total Knee Arthroplasty (TKA). The main hypothesis of this study is that a two-stage arthrodesis of the knee using a press-fit, modular intramedullary nail and antibiotic loaded cement, to fill the residual gap between the bone surfaces, prevents an excessive limb shortening, providing satisfactory clinical and functional results even without direct bone-on-bone fusion. Material and methods: The study included 22 patients who underwent knee arthrodesis between 2004 and 2009 because of recurrent infection following revision-TKA (R-TKA). Clinical and functional evaluations were performed using the Visual Analogue Scale (VAS) and the Lequesne Algofunctional Score. A postoperative clinical and radiographical evaluation of the residual limb-length discrepancy was conducted by three independent observers. Results: VAS and LAS results showed a significant improvement with respect to the preoperative condition. The mean leg length discrepancy was less than 1. cm. There were three recurrent infections that needed further surgical treatment. Discussion: This study demonstrated that reinfection after Revision of total knee Arthroplasty can be effectively treated with arthrodesis using a modular intramedullary nail, along with an antibiotic loaded cement spacer and that satisfactory results can be obtained without direct bone-on-bone fusion.
| Original language | English |
|---|---|
| Pages (from-to) | 555-559 |
| Number of pages | 5 |
| Journal | Knee |
| Volume | 19 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Oct 2012 |
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Keywords
- Arthrodesis
- Infected arthroplasty
- Intramedullary nailing
- Knee arthroplasty
- Revision
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
Cite this
Knee arthrodesis with a press-fit modular intramedullary nail without bone-on-bone fusion after an infected revision TKA. / Iacono, Francesco; Bruni, Danilo; Lo Presti, Mirco; Raspugli, Giovanni; Bondi, Alice; Sharma, Bharat; Marcacci, Maurilio.
In: Knee, Vol. 19, No. 5, 10.2012, p. 555-559.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Knee arthrodesis with a press-fit modular intramedullary nail without bone-on-bone fusion after an infected revision TKA
AU - Iacono, Francesco
AU - Bruni, Danilo
AU - Lo Presti, Mirco
AU - Raspugli, Giovanni
AU - Bondi, Alice
AU - Sharma, Bharat
AU - Marcacci, Maurilio
PY - 2012/10
Y1 - 2012/10
N2 - Introduction: Knee arthrodesis can be an effective treatment after an infected revision Total Knee Arthroplasty (TKA). The main hypothesis of this study is that a two-stage arthrodesis of the knee using a press-fit, modular intramedullary nail and antibiotic loaded cement, to fill the residual gap between the bone surfaces, prevents an excessive limb shortening, providing satisfactory clinical and functional results even without direct bone-on-bone fusion. Material and methods: The study included 22 patients who underwent knee arthrodesis between 2004 and 2009 because of recurrent infection following revision-TKA (R-TKA). Clinical and functional evaluations were performed using the Visual Analogue Scale (VAS) and the Lequesne Algofunctional Score. A postoperative clinical and radiographical evaluation of the residual limb-length discrepancy was conducted by three independent observers. Results: VAS and LAS results showed a significant improvement with respect to the preoperative condition. The mean leg length discrepancy was less than 1. cm. There were three recurrent infections that needed further surgical treatment. Discussion: This study demonstrated that reinfection after Revision of total knee Arthroplasty can be effectively treated with arthrodesis using a modular intramedullary nail, along with an antibiotic loaded cement spacer and that satisfactory results can be obtained without direct bone-on-bone fusion.
AB - Introduction: Knee arthrodesis can be an effective treatment after an infected revision Total Knee Arthroplasty (TKA). The main hypothesis of this study is that a two-stage arthrodesis of the knee using a press-fit, modular intramedullary nail and antibiotic loaded cement, to fill the residual gap between the bone surfaces, prevents an excessive limb shortening, providing satisfactory clinical and functional results even without direct bone-on-bone fusion. Material and methods: The study included 22 patients who underwent knee arthrodesis between 2004 and 2009 because of recurrent infection following revision-TKA (R-TKA). Clinical and functional evaluations were performed using the Visual Analogue Scale (VAS) and the Lequesne Algofunctional Score. A postoperative clinical and radiographical evaluation of the residual limb-length discrepancy was conducted by three independent observers. Results: VAS and LAS results showed a significant improvement with respect to the preoperative condition. The mean leg length discrepancy was less than 1. cm. There were three recurrent infections that needed further surgical treatment. Discussion: This study demonstrated that reinfection after Revision of total knee Arthroplasty can be effectively treated with arthrodesis using a modular intramedullary nail, along with an antibiotic loaded cement spacer and that satisfactory results can be obtained without direct bone-on-bone fusion.
KW - Arthrodesis
KW - Infected arthroplasty
KW - Intramedullary nailing
KW - Knee arthroplasty
KW - Revision
UR - http://www.scopus.com/inward/record.url?scp=84865380806&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84865380806&partnerID=8YFLogxK
U2 - 10.1016/j.knee.2012.01.005
DO - 10.1016/j.knee.2012.01.005
M3 - Article
C2 - 22341529
AN - SCOPUS:84865380806
VL - 19
SP - 555
EP - 559
JO - Knee
JF - Knee
SN - 0968-0160
IS - 5
ER -