title: Gastrocnemius muscle flap coverage of exposed or infected knee prostheses.
abstract: A retrospective analysis was performed of 12 patients who required soft-tissue coverage of an exposed or infected total knee prosthesis between 1982 and 1989. All knees had skin closure with medial gastrocnemius muscle flaps. At a mean follow-up period of 41 months, all patients who were treated for infected prostheses with removal of the implant, intravenous antibiotics, and muscle flap closure had an excellent clinical result with complete skin coverage and no infection. Five of the six patients went on to successful reimplantation. Of the patients with an exposed prosthesis, five of six had an excellent outcome with retention of the prosthesis. Thus, 11 of 12 patients (92%) who had medial gastrocnemius flap coverage of an exposed or infected knee prosthesis had an excellent outcome, with ten of 12 patients (82%) retaining their prostheses or having a successful reimplantation. No medial gastrocnemius flap failed after standard primary or revision total knee arthroplasty. Gastrocnemius muscle flaps provide excellent soft-tissue coverage of exposed or infected knee prostheses and facilitate surgical care of this difficult problem.
authors.affiliation: Hospital for Special Surgery, New York, New York 10021.
authors.forename: M
authors.initials: M
authors.lastname: Gerwin
authors.forename: K O
authors.initials: KO
authors.lastname: Rothaus
authors.forename: R E
authors.initials: RE
authors.lastname: Windsor
authors.forename: B D
authors.initials: BD
authors.lastname: Brause
authors.forename: J N
authors.initials: JN
authors.lastname: Insall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000637:transplantation*; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps