Updated: 7/18/2017

Knee Arthrodesis

Topic
Review Topic
0
0
Videos
1
https://upload.orthobullets.com/topic/5035/images/arthrodesis.jpg
https://upload.orthobullets.com/topic/5035/images/knee.jpg
https://upload.orthobullets.com/topic/5035/images/medium_10195_2010_89_fig6_html.jpg
https://upload.orthobullets.com/topic/5035/images/knee fusion.jpg
Introduction
  • 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
Complications
  • 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
 

Please rate topic.

Average 3.8 of 26 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
ARTICLES (1)
VIDEOS (1)
Topic COMMENTS (9)
Private Note