Abstract:
Introduction: Persistent infection after total knee arthroplasty (TKA) is a very serious complication. Arthrodesis is considered if the prosthesis cannot be retained or revision surgery is obviated. The purpose of this study was to evaluate the radiological and functional results of knee arthrodesis with Ilizarov external fixator to treat infected TKA.
Patients and methods: This was a retrospective study of 13 patients with infected TKA treated by implant removal, debridement, and fusion by Ilizarov fixator operated from October 2010 to March 2015. The study included nine females and four males with a mean age of patients of 64.08 years. Seven patients were diabetics and two had past history of deep venous thrombosis. Time, from the primary TKA till knee fusion, ranged from 18 to 37 months. All patients had previous surgical interventions with a mean of 4.62 procedures. Eleven patients had draining sinuses. In addition to clinical and radiographic evaluation, the functional assessment was done by WOMAC index questionnaire.
Results: Patients were followed-up for a mean of 28.62 months. The mean external fixator period was 7.77 months. Postoperative haematoma occurred in one patient. Pin track infection occurred in ten cases. All cases had successful fusion except two patients and infection was controlled in all cases. The mean LLD was 3.96 cm. The mean postoperative WOMAC index score was 30.08.
Conclusions: Knee arthrodesis by Ilizarov external fixator, for treating persistently infected TKA, achieved high fusion and infection control rates and provided a stable limb with pain relief and functional improvement.