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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2016

01-01-2016 | Knee

Temporary arthrodesis using fixator rods in two-stage revision of septic knee prothesis with severe bone and tissue defects

Authors: Eric Röhner, Tilman Pfitzner, Bernd Preininger, Timo Zippelius, Carsten Perka

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2016

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Abstract

Purpose

The present study describes a new temporary arthrodesis procedure, which aims for septic knee prosthesis replacement, in particular for larger bone and soft tissue defects. Our technique offers high stability and full weight-bearing capacity of the knee joint.

Methods

The study included 16 patients with major bone defects (AORI type IIb or greater) after receiving a radical debridement and a septic two-stage revision total knee arthroplasty. After removing the infected prosthesis and debridement, two AO fixator rods were positioned into the intramedullary space of the femur and tibia. Subsequently, both rods were joined tube-to-tube and adjusted in the center of the knee joint. Finally, the whole cavity of the knee joint was filled with PMMA. The number of previous surgeries, bacterial spectrum, risk factors for further infection and reinfection rates was recorded. Immediately after the temporary arthrodesis, radiographs of the knee with the enclosed spacers were taken in order to compare to previous radiographs and avoiding to miss possible spacer loosening.

Results

Nine of sixteen patients underwent more than two revision surgeries before receiving our new arthrodesis technique. No cases of spacer loosening were observed in all 16 patients; further, there were no peri-implant fractures, and four persistent infections were noted.

Conclusions

Temporary arthrodesis using AO fixator rods offers a high stability without loosening. Its potential to replace conventional augmentation techniques should be taken into account, particularly in the case of larger bone and tissue defects. In clinical practice, the cemented spacer using AO fixator rods could be an alternative technique for temporary knee arthrodesis after septic debridement.

Level of evidence

Retrospective case series, Level IV.
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Metadata
Title
Temporary arthrodesis using fixator rods in two-stage revision of septic knee prothesis with severe bone and tissue defects
Authors
Eric Röhner
Tilman Pfitzner
Bernd Preininger
Timo Zippelius
Carsten Perka
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3324-7

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