Arthrodesis of the knee with a vascularized fibular rotatory graft.
We retrospectively reviewed the records of thirteen patients who had been managed with an arthrodesis of the knee with use of a vascularized graft from the ipsilateral fibula and fixation with an intramedullary rod. The indications for the operation included a large skeletal defect secondary to the resection of a tumor about the knee in eight patients, an infection at the site of an arthroplasty in four (with failure of a previous conventional arthrodesis in three of the four), and severe rheumatoid gonarthrosis as well as a persistent non-union of the distal part of the femur in one. The average age of the patients at the time of the operation was forty-three years (range, twenty-six to seventy-six years). Most of the patients had had multiple previous procedures (thirty-three operations had been performed in ten patients). Twelve of the thirteen patients had a solid fusion and a successful result after an average duration of follow-up of fifty-one months (range, eight to ninety-three months). The remaining patient, who had had four previous arthroplasties, had a recurrence of an infection seven months after the operation and was managed with an amputation. Six complications--including two superficial wound infections, one deep wound infection, one deep venous thrombosis, one transient peroneal-nerve palsy, and one delayed union--occurred in three patients.
Rasmussen
M R
MR
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905, USA.
Bishop
A T
AT
Wood
M B
MB
D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000379:methods*; D001858:Bone Nails; D001859:Bone Neoplasms / Q000601:surgery; D005260:Female; D005360:Fibula / Q000637:transplantation*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D016459:Prosthesis-Related Infections / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000379:methods