Updated: 7/18/2017

Knee Arthrodesis

Review Topic
1 1
https://upload.orthobullets.com/topic/5035/images/knee fusion.jpg
  • Indications
    • painful ankylosis after infection or trauma
    • neuropathic arthropathy
    • tumor resection
    • salvage for failed TKA (most common)
    • loss of extensor mechanism
  • Contraindications
    • absolute
      • active infection
    • relative
      • bilateral knee arthrodesis
      • contralateral leg amputation
      • significant bone loss
      • ipsilateral hip or ankle DJD
  • Optimal Position
    • 5-8° valgus
    • 0-10° of external rotation (match other leg)
    • 0-15° of flexion
    • some limb shortening advantageous for patient self-care
Surgical Technique
  • Intramedullary rod fixation 
    • technique
      • can be one long antegrade device or a two part device connected at the knee
      • patella can be left alone or incorporated into arthrodesis
  • External fixation 
    • technique
      • must allow compression of arthrodesis site
      • done with unilateral external fixation, Ilizarov, or Taylor Spatial Frame
  • Plate fixation 
    • technique
      • can be done alone in combination with intramedullary nailing
  • Nonunion
  • Infection
  • Low back pain
  • Ipsilateral hip degenerative changes
  • Contralateral knee degenerative changes
  • Fracture
    • supracondylar femur or proximal tibial metaphysis fractures
      • these occur from increased stress in these regions after arthrodesis

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