- See:
Arthrodesis following TKR:
- PreOp Planning for Arthrodesis:
- Discussion:
- arthrodesis provides potential of a painless, stable base of support but it does so at the expense of knee motion;
- optimal position of arthrodesis:
- slight valgus, 10 deg of external rotation, and 0-20 deg of flexion (knees that have been shortened due
to previous arthroplasty should be fused in full extension);
- valgus alignment with slight flexion easier to obtain with an external fixator than w/ IM nail;
- IM nails tend to cause 2-5 deg of varus;
- note that if future total knee replacement is a consideration (fusion takedown and arthroplasty) then it is important that the
patella not be included in the fusion;
-
contra-indications:
- bilateral knee disease;
- ipsilateral ankle or hip disease;
- severe segmental bone loss;
- contralateral leg amputation;
- Techniques of Arthrodesis:
-
External Fixation:
-
Intramedullary Nailing Arthrodesis:
-
Plate Fixation:
- Complications:
-
non union:
- most frequent complication of arthrodesis is non-union.
- etiology of non-union includes bone loss, persistent infection, incomplete bone apposition,
limb malalignment, and inadequate immobilization;
Knee arthrodesis following total knee arthroplasty in rheumatoid arthritis.
Long-term evaluation of hip arthroplasty in patients with an ipsilateral knee arthrodesis.
Arthrodesis of the knee with a vascularized fibular rotatory graft.
