title: Outcome after knee arthrodesis for failed septic total knee replacement using a monolateral external fixator.
abstract: OBJECTIVE
  To evaluate the pain level and patient satisfaction as well as the fusion and infection eradication rates after knee arthrodesis using a monolateral external fixator for failed septic total knee replacement (TKR).
  
  
  METHODS
  Records of 10 male and 11 female consecutive patients aged 70 to 88 (mean, 81) years who underwent knee arthrodesis using a monolateral external fixator for failed septic TKR were retrospectively reviewed. Each patient had undergone a mean of 3.4 (range, 1-15) procedures. The infection eradication rate, fusion rate, time to achieve fusion, pain level, patient satisfaction, and health-related quality of life were evaluated.
  
  
  RESULTS
  Infection was eradicated in 18 (86%) of the 21 patients, whereas fusion was achieved in 17 (81%) of the 21 patients after a mean of 10.3 (range, 4-16) months. Those who did and did not achieve fusion differed significantly in terms of the mean pain score (2.3 vs. 6.4, p=0.031). Compared with age-matched Spanish general population, patients aged >75 years fared significantly worse in terms of the mean physical summary component score (40.7 vs. 34.9, p=0.001). Among those who achieved fusion, 82% were very or somewhat satisfied; none was very dissatisfied. Among those who did not achieve fusion, 75% were very or somewhat dissatisfied.
  
  
  CONCLUSIONS
  Knee arthrodesis using a monolateral external fixator for failed septic TKR achieved high fusion and infection eradication rates, despite the extended time needed. When fusion is achieved, patients had good pain relief and satisfaction.
authors.affiliation: Department of Orthopaedic Surgery, Hospital Universitario Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Pablo S
authors.initials: PS
authors.lastname: Corona
authors.forename: Alejandro
authors.initials: A
authors.lastname: Hernandez
authors.forename: M Mercedes
authors.initials: MM
authors.lastname: Reverte-Vinaixa
authors.forename: Carles
authors.initials: C
authors.lastname: Amat
authors.forename: Xavier
authors.initials: X
authors.lastname: Flores
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000295:instrumentation*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000601:surgery*; D011788:Quality of Life; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: arthrodesis; arthroplasty, replacement,
  knee; external fixators; infection; quality of life