title: Limb salvage after infected knee arthroplasty with bone loss and extensor mechanism deficiency using a modular segmental replacement system.
abstract: Multiple total knee arthroplasty revisions pose significant surgical challenges, such as bone loss and soft tissue compromise. For patients with bone loss and extensor mechanism insufficiency after total knee arthroplasty, arthrodesis is a treatment option for the avoidance of amputation. However, arthrodesis is both difficult to achieve in situations with massive bone loss and potentially undesirable due to the dramatic shortening that follows. Although intramedullary nailing for knee arthrodesis has been widely reported, this technique has traditionally relied on the achievement of bony union. We report a case of a patient with massive segmental bone loss in which a modular intercalary prosthesis was used for arthrodesis to preserve limb length without bony union.
authors.affiliation: Department of Orthopedic Surgery, Minneapolis Veterans AffairsMedical Center, Minneapolis, MN 55417, USA.
authors.forename: Surena
authors.initials: S
authors.lastname: Namdari
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Milby
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Garino
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods*; D001843:Bone Cements; D001858:Bone Nails; D001862:Bone Resorption / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D007720:Knee Prosthesis / Q000009:adverse effects*; D023821:Limb Salvage / Q000379:methods*; D011475:Prosthesis Failure / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000150:complications* / Q000188:drug therapy; D011859:Radiography; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements