Knee arthrodesis with the Ilizarov external fixator as treatment for septic failure of knee arthroplasty.
BACKGROUND
The authors report the results of femoral-tibial fusion with an Ilizarov circular external fixator following septic loosening of knee prosthesis.


METHODS
The series included 17 patients with a mean age of 62.9 years, treated from 1990 to 2007 with femoral-tibial fusion. The Cierny-Mader classification was used for clinical and anatomopathological evaluation; the Engh classification was used to assess the bone defect. Surgical treatment differed according to these criteria.


RESULTS
Healing was achieved in 13 out of 17 patients at the first surgical attempt in a mean time of 9.3 months. Mean follow-up was 30 months. Of the four complications, two patients had an intolerance to the external fixator that led to its early removal, and the other two had a septic intraarticular nonunion.


CONCLUSIONS
The Ilizarov circular external fixator is a very reliable fixation system due to its low cost, versatility, stability under load, and low risk of septic dissemination. Nevertheless, an appropriate patient selection and a good surgeon's experience are necessary.
Spina
M
M
VII Department of Orthopedic Surgery, Rizzoli Orthopedic Institute, University of Bologna, Bologna, Italy. spina.mauro@gmail.com
Gualdrini
G
G
Fosco
M
M
Giunti
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods* / Q000592:standards; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D004867:Equipment Design; D016267:External Fixators / Q000592:standards*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D018805:Sepsis / Q000188:drug therapy / Q000209:etiology*; D017211:Treatment Failure
D000900:Anti-Bacterial Agents