title: Total knee arthroplasty after osseous ankylosis of the knee joint.
abstract: OBJECTIVE
  A knee fusion is associated with considerable restrictions, including the inability to sit properly, use public transportation, and climb stairs. The purpose of this study is to report and discuss our cases of spontaneous ankylosed knees which were taken down and underwent total knee arthroplasty (TKA).
  
  
  METHODS
  Six patients who experienced spontaneous ankylosis of the knee undergoing conversion to TKA between 2003-2012 were enrolled retrospectively in this study. The etiology was childhood pyogenic arthritis in 2 patients, intraarticular fractures in 2, gunshot in 1, and juvenile rheumatoid arthritis in 1. The clinical data were recorded with the use of the Hospital for Special Surgery (HSS) knee rating system, Western Ontario and McMaster Questionnaire (WOMAC), and Visual Analog Scale (VAS), preoperatively and postoperatively at final follow-up.
  
  
  RESULTS
  The average follow-up time was 86 months (range: 22-126 months). At the final follow-up, the average range of active flexion was 85° (range: 75-95°). Postoperative average HSS knee rating system was improved from 19.5 (range: 18-22) to 57.49 (range: 46-80), WOMAC was improved from 39.75 (range: 36.4-43) to 62.41 (range: 50.8-74.5). VAS was improved from 9.5 (range: 7-9) to 2.8 (range: 2-4). A pyogenic infection developed in 2 patients; 1 was managed by debridement, and 1 was managed by arthrodesis 2 years later.
  
  
  CONCLUSIONS
  The ability to walk and sit in a normal fashion is of great importance for patients. With good preoperative planning and careful handling, gratifying results are possible with TKA.
authors.affiliation: İstanbul Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors.forename: Emrah
authors.initials: E
authors.lastname: Kovalak
authors.affiliation: İstanbul Surgery Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors.forename: Ata
authors.initials: A
authors.lastname: Can
authors.affiliation: İstanbul Surgery Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors.forename: Neşe
authors.initials: N
authors.lastname: Stegemann
authors.affiliation: Beşiktaş Sait Çiftçi State Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors.forename: Ayşe Övül
authors.initials: AÖ
authors.lastname: Erdoğan
authors.affiliation: İstanbul University Cerrahpaşa Faculty of Medicine, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors.forename: Fahri
authors.initials: F
authors.lastname: Erdoğan
mesh_terms: D000328:Adult; D000844:Ankylosis / Q000534:rehabilitation* / Q000601:surgery*; D001170:Arthritis, Infectious; D001174:Arthrodesis; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D003646:Debridement; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016138:Walking; D055815:Young Adult