Septic single-stage knee arthrodesis after failed total knee arthroplasty using a cemented coupled nail.
Knee arthrodesis is a potential salvage procedure for limb preservation after failure of total knee arthroplasty (TKA) due to infection. In this study, we evaluated the outcome of single-stage knee arthrodesis using an intramedullary cemented coupled nail without bone-on-bone fusion after failed and infected TKA with extensor mechanism deficiency. Between 2002 and 2012, 27 patients (ten female, 17 male; mean age 68.8 years; 52 to 87) were treated with septic single-stage exchange. Mean follow-up duration was 67.1months (24 to 143, n = 27) (minimum follow-up 24 months) and for patients with a minimum follow-up of five years 104.9 (65 to 143,; n = 13). A subjective patient evaluation (Short Form (SF)-36) was obtained, in addition to the Visual Analogue Scale (VAS). The mean VAS score was 1.44 (SD 1.48). At final follow-up, four patients had recurrent infections after arthrodesis (14.8%). Of these, three patients were treated with a one-stage arthrodesis nail exchange; one of the three patients had an aseptic loosening with a third single-stage exchange, and one patient underwent knee amputation for uncontrolled sepsis at 108 months. All patients, including the amputee, indicated that they would choose arthrodesis again. Data indicate that a single-stage knee arthrodesis offers an acceptable salvage procedure after failed and infected TKA.
Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
N
N
Hawi
Helios ENDO-Klinik, Hamburg, Holstenstr. 2, 22767 Hamburg, Germany.
D
D
Kendoff
Helios ENDO-Klinik, Hamburg, Holstenstr. 2, 22767 Hamburg, Germany.
M
M
Citak
Helios ENDO-Klinik, Hamburg, Holstenstr. 2, 22767 Hamburg, Germany.
T
T
Gehrke
Helios ENDO-Klinik, Hamburg, Holstenstr. 2, 22767 Hamburg, Germany.
C
C
Haasper
D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods; D001843:Bone Cements; D001858:Bone Nails; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000601:surgery*
D001843:Bone Cements
PJI; failed TKR; intramedullary; knee arthrodesis; single-stage exchange