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Knee arthrodesis with modular nail after failed TKA due to infection

Gallusser, Nicolas ; Goetti, Patrick ; Luyet, Anais ; Borens, Olivier

In: European Journal of Orthopaedic Surgery & Traumatology, 2015, vol. 25, no. 8, p. 1307-1312

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    Titre
    • Knee arthrodesis with modular nail after failed TKA due to infection
    Auteur
    • Gallusser, Nicolas. Département de l'appareil locomoteur, Centre Hospitalier Universitaire Vaudois, Service d'orthopédie et traumatologie, University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Goetti, Patrick. Département de l'appareil locomoteur, Centre Hospitalier Universitaire Vaudois, Service d'orthopédie et traumatologie, University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Luyet, Anais. Département de l'appareil locomoteur, Centre Hospitalier Universitaire Vaudois, Service d'orthopédie et traumatologie, University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Borens, Olivier. Département de l'appareil locomoteur, Centre Hospitalier Universitaire Vaudois, Service d'orthopédie et traumatologie, University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • European Journal of Orthopaedic Surgery & Traumatology, 2015, vol. 25, no. 8, p. 1307-1312. Springer Paris
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:332855
    Summary
    Introduction: Knee arthrodesis is an established procedure for limb salvage after failed total knee arthroplasty (TKA) in cases of recurrent infection, soft tissue damage, reduced bone stock or with a deficient extensor mechanism. Walking with an arthrodesis is more efficient and less costly in terms of energy expenditure than above-knee amputation. Surgical options include an arthrodesis nail, external fixator or compression plate. We present our results of knee arthrodesis using the modular Wichita Fusion Nail® in patients after infected TKA. Methods: Fifteen patients with irretrievably failed TKA, due to infection, who underwent arthrodesis with the Wichita Fusion Nail® from 2004 to 2012 were retrospectively reviewed to assess fusion rate, time to fusion, complication rate, including new infections, and ambulatory status. Results: Three patients were lost to follow-up. Mean follow-up was 33months (6-132months). At their most recent follow-up, all patients were walking with full weight bearing on a fused arthrodesis. Mean time to union was 9months (3-29months). Three patients necessitated a revision arthrodesis to achieve union after a mean of 5months after the last procedure. Conclusion: Arthrodesis with the Wichita Fusion Nail® provides satisfactory results in patients with failure after infected TKA, with 75% primary union rate and no new or persistent infection at last follow-up visit. Although burdened with a high complication rate, it represents an acceptable option for limb salvage in this particular pathology.