Application of the Ilizarov apparatus in knee arthrodesis as a treatment option after infected total knee arthroplasty

Abstract

A chronic periprosthetic infection with attendant failure of the knee extensor mechanism is one of the most disastrous outcome following total knee arthroplasty and knee arthrodesis may be the last possible option treatment with the exception lover limb amputated. The aim of this study is to represent the results to achieve knee arhrodesis in patients with chronically septic total knee arhroplasty. In our retrospective study we reviewed the clinical record of 27 patients who were treated with Ilizarov circular external fixator for this condition. Male to female ratio was 13:14. Main age of the patients was 62,3 years. We used Cierny-Mader classification for the clinical and pathoanatomical assessment. For the assessment of the bone defect we used Engh classification. Complete union we had in 22(81,4%) patients. Mean time for healing was 5,7 months, range (3-15). Mean residual limb shortness was 4,7 cm and mean follow-up was 21 months. We also had a five nonunion (18,6%) complications: three with septic intrarticular nonunion, two had intolerance to the Ilizarov apparatus, so we removed earlier. The Ilizarov circular external fixator provides us a high rate of bone healing and low risk of septic dissemination in patients with infected total knee arthroplasty (TKA).