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

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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.


Large skin defect of the knee region.
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Figure 11: Large skin defect of the knee region.

Mentions: Between 64% and 100% of the patients treated with the Ilizarov technique demonstrated a successful arthrodesis.18–19 This kind of fixation is almost a noninvasive method of immobilizing of a joint. It is important if the patient has previously suffered from Stapylococcus aureus infection.12,20,21 The Ilizarov apparatus allows the compression of the fixed elements to be maintained and controlled, provides stabilization, allows early weight bearing and it can be applied even during an ongoing infection.21,22 Extensive cicatricial skin lesions observed in the knee area were an indication for the selection of this particular method in the current case (Figure 11). Numerous surgical scars with signs of keloids, combined with the poor condition of the surrounding skin seen in the patient, might have caused complications in the healing process, and these factors provided indications for arthroscopic-assisted arthrodesis. The removal of the articular cartilage and preparation of the articular surface for fusion with the use of an arthroscope prevented the poor skin from being surgically invaded, which reduced the traumatization of soft tissues.


Arthroscopic-assisted Arthrodesis of the Knee Joint With the Ilizarov Technique
Large skin defect of the knee region.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 11: Large skin defect of the knee region.
Mentions: Between 64% and 100% of the patients treated with the Ilizarov technique demonstrated a successful arthrodesis.18–19 This kind of fixation is almost a noninvasive method of immobilizing of a joint. It is important if the patient has previously suffered from Stapylococcus aureus infection.12,20,21 The Ilizarov apparatus allows the compression of the fixed elements to be maintained and controlled, provides stabilization, allows early weight bearing and it can be applied even during an ongoing infection.21,22 Extensive cicatricial skin lesions observed in the knee area were an indication for the selection of this particular method in the current case (Figure 11). Numerous surgical scars with signs of keloids, combined with the poor condition of the surrounding skin seen in the patient, might have caused complications in the healing process, and these factors provided indications for arthroscopic-assisted arthrodesis. The removal of the articular cartilage and preparation of the articular surface for fusion with the use of an arthroscope prevented the poor skin from being surgically invaded, which reduced the traumatization of soft tissues.

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.