title: Knee arthrodesis with the Vari-Wall nail for treatment of infected total knee arthroplasty.
abstract: We reviewed 20 patients who had undergone one-stage (7 cases) or two-stage (13 cases) knee arthrodesis using the Vari-Wall intramedullary nail, as a salvage operation following infection of a total knee arthroplasty. The procedure was followed by systemic antibiotic administration and early rehabilitation. Intraoperative microbiological cultures were taken. The average period of follow-up was 20 months. Solid union was achieved in 80%; mean time to fusion was 9 months. There was no recurrence of infection. The average limb length discrepancy was 2.45 cm. A walking aid was needed by 95% of the patients. The complication rate was 30% including 4 pseudarthroses, one intraoperative fracture and one peroneal nerve palsy. The Vari-Wall intramedullary nail is a good option when an arthrodesis is indicated for salvage of an infected total knee arthroplasty. It can be performed in one or two stages depending on several factors such as microbiologic culture results. It achieved good pain relief and acceptable functional results in this study.
authors.affiliation: University Hospital Reina Sofia, Cordoba, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Garcia-Lopez
authors.forename: Miguel Anguel
authors.initials: MA
authors.lastname: Aguayo
authors.forename: Antonio
authors.initials: A
authors.lastname: Cuevas
authors.forename: Pablo
authors.initials: P
authors.lastname: Navarro
authors.forename: Cristobal
authors.initials: C
authors.lastname: Prieto
authors.forename: Pedro
authors.initials: P
authors.lastname: Carpintero
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods; D001858:Bone Nails; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D016138:Walking