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Arthroscopic-assisted Arthrodesis of the Knee Joint With the Ilizarov Technique

View Article: PubMed Central - PubMed

ABSTRACT

Arthrodesis of the knee joint is a mainly a salvage surgical procedure performed in cases of infected total knee arthroplasty, tumor, failed knee arthroplasty or posttraumatic complication.

The authors report the case of 18-year-old male with posttraumatic complication of left knee because of motorbike accident 1 year before. He was treated immediately after the injury in the local Department of Orthopaedics and Traumatology. The examination in the day of admission to our department revealed deformation of the left knee, massive scar tissue adhesions to the proximal tibial bone and multidirectional instability of the knee. The plain radiographs showed complete lack of lateral compartment of the knee joint and patella. The patient complained of severe instability and pain of the knee and a consecutive loss of supporting function of his left limb. The authors decided to perform an arthroscopic-assisted fusion of the knee with Ilizarov external fixator because of massive scar tissue in the knee region and the prior knee infection.

In the final follow-up after 54 months a complete bone fusion, good functional and clinical outcome were obtained.

This case provides a significant contribution to the development and application of low-invasive techniques in large and extensive surgical procedures in orthopedics and traumatology. Moreover, in this case fixation of knee joint was crucial for providing good conditions for the regeneration of damaged peroneal nerve.

No MeSH data available.


Fifty-four weeks after the surgery.
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Figure 9: Fifty-four weeks after the surgery.

Mentions: The limb remained immobilized in the Ilizarov apparatus for a total period of 42 weeks (Figures 5 and 6). Owing to persistent pain in the arthrodesis region, it was decided to immobilize the limb in a plaster cast for the next 6 weeks and then in a plaster splint for another 6 weeks. At the end of this period, check-up computed tomography was performed to confirm complete bone fusion (Figures 7 and 8). After the surgery, the patient walked with forearm crutches. He was advised to avoid putting his full weight on the limb for the first 2 weeks, although partial and gradual weight bearing was permitted after this period. Finally, after a period of 6 weeks, full weight bearing was recommended (Figures 9 and 10). Follow-up radiologic examinations were performed soon after the surgery, then after 3 weeks and every 6 weeks until the removal of the apparatus. Radiographic examinations were assessed by independent radiologists. The subsequent examinations confirmed gradual bone fusion. Over the whole immobilization period, no major infections were noted in the area treated with the Ilizarov technique or any signs of inflammatory processes in the joint or bones.


Arthroscopic-assisted Arthrodesis of the Knee Joint With the Ilizarov Technique
Fifty-four weeks after the surgery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998273&req=5

Figure 9: Fifty-four weeks after the surgery.
Mentions: The limb remained immobilized in the Ilizarov apparatus for a total period of 42 weeks (Figures 5 and 6). Owing to persistent pain in the arthrodesis region, it was decided to immobilize the limb in a plaster cast for the next 6 weeks and then in a plaster splint for another 6 weeks. At the end of this period, check-up computed tomography was performed to confirm complete bone fusion (Figures 7 and 8). After the surgery, the patient walked with forearm crutches. He was advised to avoid putting his full weight on the limb for the first 2 weeks, although partial and gradual weight bearing was permitted after this period. Finally, after a period of 6 weeks, full weight bearing was recommended (Figures 9 and 10). Follow-up radiologic examinations were performed soon after the surgery, then after 3 weeks and every 6 weeks until the removal of the apparatus. Radiographic examinations were assessed by independent radiologists. The subsequent examinations confirmed gradual bone fusion. Over the whole immobilization period, no major infections were noted in the area treated with the Ilizarov technique or any signs of inflammatory processes in the joint or bones.

View Article: PubMed Central - PubMed

ABSTRACT

Arthrodesis of the knee joint is a mainly a salvage surgical procedure performed in cases of infected total knee arthroplasty, tumor, failed knee arthroplasty or posttraumatic complication.

The authors report the case of 18-year-old male with posttraumatic complication of left knee because of motorbike accident 1 year before. He was treated immediately after the injury in the local Department of Orthopaedics and Traumatology. The examination in the day of admission to our department revealed deformation of the left knee, massive scar tissue adhesions to the proximal tibial bone and multidirectional instability of the knee. The plain radiographs showed complete lack of lateral compartment of the knee joint and patella. The patient complained of severe instability and pain of the knee and a consecutive loss of supporting function of his left limb. The authors decided to perform an arthroscopic-assisted fusion of the knee with Ilizarov external fixator because of massive scar tissue in the knee region and the prior knee infection.

In the final follow-up after 54 months a complete bone fusion, good functional and clinical outcome were obtained.

This case provides a significant contribution to the development and application of low-invasive techniques in large and extensive surgical procedures in orthopedics and traumatology. Moreover, in this case fixation of knee joint was crucial for providing good conditions for the regeneration of damaged peroneal nerve.

No MeSH data available.