J Korean Orthop Assoc.  2014 Feb;49(1):79-84. 10.4055/jkoa.2014.49.1.79.

Artificial Fusion of Infected Total Knee Arthroplasty Using a Flexible Intramedullary Rod Bundle and an Antibiotic-Loaded Cement Spacer

Affiliations
  • 1Department of Orthopaedic Surgery, Korea University Anam Hospital, Seoul, Korea. oshan@korea.ac.kr
  • 2Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.
  • 3Department of Orthopaedic Surgery, VHS Medical Center, Seoul, Korea.

Abstract

Multiple total knee arthroplasty (TKA) failure resulting from a recurrent infection is a challenging problem. Knee arthrodesis is one treatment option that normally involves the application of an external fixator, plate fixation, and intramedullary nailing. However, these approaches are not always successful, and a reinfection is a risk, particularly in older, medically compromised patients. This paper reports a new arthrodesis technique that uses a bundle of flexible intramedullary rods and an antibiotic-loaded cement spacer. This technique was used in two cases of multiple TKA failure that resulted from a recurrent infection. The procedure was successful in both cases with no evidence of rod or cement failure. Two advantages of this procedure are infection eradication and mechanical strength. However, this procedure should only be used for medically compromised elderly patients at high risk of rerevision TKA failure resulting from persistent periprosthetic infection because rod fracture or loosening can occur with time.

Keyword

total knee arthroplasty; infection; artificial fusion; antibiotic-loaded cement spacer

MeSH Terms

Aged
Arthrodesis
Arthroplasty*
External Fixators
Fracture Fixation, Intramedullary
Humans
Knee*
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