title: Flaps for closure of soft tissue defects in infected revision knee arthroplasty.
abstract: OBJECTIVE
  Total knee arthroplasty revision has wound healing deficits of up to 20 %. Defects in the knee region of multimorbid patients are hard to treat as complete explantation and revision arthroplasty is often too burdensome for them. In this study, we present our results with flaps for the treatment of defects after knee replacement, arthrodesis or osteosynthesis.
  
  
  METHODS
  Twenty-five patients (26 knees) with defects in the knee region were treated with flaps. Mean follow-up was 37 months (13-61) and the patients had a mean age of 72 years (49-85). A total of 39 flaps were performed (27 muscle flaps, seven fascio-cutaneous flaps and five free flaps).
  
  
  RESULTS
  Patients with more than three comorbidities showed higher risk of complications after surgery. Fifteen patients showed no infection at last follow up. Five patients received an arthrodesis of the knee, two showed persistent infection of the implant with fistula, and three were amputated above the knee.
  
  
  CONCLUSIONS
  Amputation could be avoided in 22 cases (85 %). The gastrocnemius muscle flap showed good results in the treatment of defects after arthroplasty or arthrodesis of the knee in multimorbid patients. This procedure can be used if further revision surgery is not indicated.
authors.affiliation: Department for Septic Surgery, Trauma Center Ludwigshafen, Ludwigshafen, Germany, arnold@drsuda.com.
authors.forename: Arnold J
authors.initials: AJ
authors.lastname: Suda
authors.forename: Angela
authors.initials: A
authors.lastname: Cieslik
authors.forename: Paul A
authors.initials: PA
authors.lastname: Grützner
authors.forename: Matthias
authors.initials: M
authors.lastname: Münzberg
authors.forename: Volkmar
authors.initials: V
authors.lastname: Heppert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D013524:Surgical Flaps; D014945:Wound Healing; D014947:Wounds and Injuries / Q000601:surgery