Knee arthrodesis

Abstract

Knee arthrodesis is becoming increasingly more common as a solution for complications following total knee arthroplasty. The following article summarizes the current literature regarding this option for limb salvage.

The most common indication for knee fusion today is for complications following failed total knee arthroplasty. The surgical challenges affecting this population include massive bone loss, infection and loss of soft-tissue envelope. In addition, this often older population frequently has multiple co-morbidities including diabetes, heart disease and peripheral vascular disease. Knee arthrodesis can be achieved using a variety of surgical techniques such as external fixation, short or long intramedullary rod fixation and dual plating techniques. Choice of surgical technique is dependent upon the presence of an active infection and the integrity of the soft-tissue envelope. Bone grafting of the arthrodesis site is frequently needed to achieve a solid union. A stable knee arthrodesis provides a stable, painless, uninfected limb for walking that requires less energy than the alternative above-the-knee amputation.

This review summarizes the current literature regarding knee arthrodesis and provides a rationale for choosing knee arthrodesis as a salvage procedure as well as choosing the most effective technique for arthrodesis.