title: Bridging knee arthrodesis for limb salvage using an intramedullary cemented nail: a retrospective outcome analysis of a case series.
abstract: BACKGROUND
  Failed total knee replacement with compromised bone and soft-tissues can be challenging. In these situations, arthrodesis remains a treatment option of a limb-saving procedure.
  
  
  METHODS
  We investigated the outcome of treatment with an intramedullary cemented knee arthrodesis nail implanted in 22 consecutive patients with forlorn situations after failed total knee replacement.
  
  
  RESULTS
  There were three major complications due to re-infection and two minor complications due to wound-healing disturbances that healed with the implant retained after an average follow-up of 3.4 years. Clinical examination, Short Form-36 and Oxford knee scores revealed low pain levels, safe implant anchorage, and improved stability of the knee, whilst autonomous mobility utilizing walking aids was still possible.
  
  
  CONCLUSIONS
  Bridging knee arthrodesis with an intramedullary nail is a valuable salvage procedure with acceptable clinical results. As recurring infection remains the most challenging complication, regular clinical and radiological follow-up examinations are necessary following implant-related knee arthrodesis to allow timely intervention in case of loosening.
authors.affiliation: Department of Orthopaedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany.
authors.forename: Carl
authors.initials: C
authors.lastname: Neuerburg
authors.forename: Ralf
authors.initials: R
authors.lastname: Bieger
authors.forename: Sebastian
authors.initials: S
authors.lastname: Jung
authors.forename: Thomas
authors.initials: T
authors.lastname: Kappe
authors.forename: Heiko
authors.initials: H
authors.lastname: Reichel
authors.forename: Ralf
authors.initials: R
authors.lastname: Decking
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000379:methods*; D001843:Bone Cements; D001858:Bone Nails; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis / Q000009:adverse effects*; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements