Z Orthop Unfall
DOI: 10.1055/a-0869-8190
Original Article/Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Arthrodesis of the Infected Knee Joint with the Ilizarov External Fixator: an Analysis of 13 Cases

Article in several languages: English | deutsch
Charlotte Reinke
Surgical Clinic and Polyclinic, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum
,
Hinnerk Bäcker
Surgical Clinic and Polyclinic, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum
,
Sebastian Lotzien
Surgical Clinic and Polyclinic, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum
,
Thomas A. Schildhauer
Surgical Clinic and Polyclinic, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum
,
Dominik Seybold
Surgical Clinic and Polyclinic, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum
,
Jan Gessmann
Surgical Clinic and Polyclinic, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum
› Author Affiliations
Further Information

Publication History

Publication Date:
18 September 2019 (online)

Abstract

Background Knee joint infections with pronounced joint destruction, soft tissue and bone involvement are serious diseases in which not only the joint but also the entire extremity are directly endangered. What results can be achieved with the Ilizarov external fixator for septic knee arthrodesis?

Patients and Methods Between 2005 and 2017, 13 patients (4 women and 9 men, mean age 46 years) with acute joint and concomitant bone and soft-tissue infections were treated with Ilizarov knee joint arthrodesis. In addition to demographic data, the time spent in the fixator, major and minor complications were retrospectively evaluated.

Results The average time spent in the Ilizarov external fixator was 27 weeks (min. 13, max. 68). Arthrodesis and infection repair were primarily achieved in 12 out of 13 patients. In one patient, a delayed healing of the arthrodesis zone could be cured by iliac crest bone grafting, so that eventually a bony knee arthrodesis was achieved in all patients. Pin infects as a minor complication during the time spent in the fixator were common and could be treated by stab incision and antibiotics. Major complications occurred in 3 cases (2 femoral fractures peri-implant, 1 nonunion in the arthrodesis area), which were treated by dilatation of the Ilizarov external fixator and finally plate osteosynthesis or by resection of the pseudarthrosis and iliac crest bone grafting.

Conclusion The knee joint arthrodesis with the Ilizarov external fixator is a salvage procedure for limb preservation in fulminant knee joint and concomitant soft tissue infections. The advantages lie in the possibility of osteosynthesis in the acute infection and/or chronic osteomyelitis and the direct full load capacity. Disadvantages are long and complicated treatment times in the fixator with limited patient comfort.