SALVAGE PROCEDURES FOR FAILED TOTAL KNEE ARTHROPLASTY
| Autor: | Michael J. Christie, David K. DeBoer, Francis W. Cooke, David A. McQueen, Dustan L. Hahn |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Reoperation
medicine.medical_specialty Prosthesis-Related Infections Reconstructive Surgeon Knee Joint medicine.medical_treatment Arthrodesis Total knee arthroplasty Aseptic loosening Prosthesis Humans Medicine Orthopedics and Sports Medicine Treatment Failure Arthroplasty Replacement Knee Salvage Therapy business.industry General Medicine Prosthesis Failure Surgery Chronic infection Amputation Orthopedic surgery business |
| Zdroj: | The Journal of Bone and Joint Surgery-American Volume. 85:58-62 |
| ISSN: | 0021-9355 |
| DOI: | 10.2106/00004623-200300001-00011 |
| Popis: | Revision total knee arthroplasty for aseptic loosening or following infection can pose formidable challenges to the reconstructive surgeon. In some cases, the patient will undergo a series of operations, each resulting in ever-increasing bone loss. In extreme circumstances, the end result may be amputation, arthrodesis, or permanent resection arthroplasty. Isiklar et al.1, in a study of amputation following total knee arthroplasty, found that patients had undergone an average of six operative procedures prior to having an amputation. In a review of patients who had a reinfection following reimplantation for an infection at the site of a total knee arthroplasty, Hanssen et al.2 found that patients had undergone an average of thirteen operative procedures. Although amputation or permanent resection arthroplasty results in a poor outcome that can be avoided in most patients, situations in which these options should be considered include life-threatening infection, persistent infection, irreparable soft-tissue deficiency, severe bone loss, and the wishes of the patient following multiple failed attempts at reconstruction. Resection arthroplasty may be best tolerated by patients who are willing to accept loss of ambulation, such as those who are already disabled because of multiple joint involvement. The prevalence of amputation following total knee arthroplasty has ranged from 0.02% to 0.18%, but it has been reported to be 6% in patients with a chronic infection at the site of a total knee arthroplasty1,3-5. The outcome of amputation or resection arthroplasty following total knee arthroplasty is predictably poor, with a low likelihood of ambulation. Isiklar et al.1 reported on a series of nine above-the-knee amputations in eight patients. The mean interval between the first total knee arthroplasty and the amputation was 9.7 years. Eight of the nine amputations were performed for infection with severe bone loss, and one … |
| Databáze: | OpenAIRE |
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