Abstract
The failed total knee arthroplasty is a challenge to the surgeon and the patient.
Infection, bone loss, and instability lead to a chronically painful and dysfunctional
limb. Two-stage revision arthroplasty has been successful in clearing a majority of
periprosthetic joint infections. However, there are many cases when the multiply revised
and infected total knee arthroplasty cannot be salvaged. We report, a review of knee
arthrodesis and a novel technique to manage significant bone loss. The use of trabecular
metal cones and a long intramedullary nail can be used in concert with an autologous
intramedullary bone graft to provide a stable, length restoring construct with sufficient
biology to heal very large bone voids. With this technique we have successfully restored
function and stability in the failed knee arthroplasty.
Keywords
knee arthrodesis - infection - total knee arthroplasty - multiple total knee revisions
- trabecular metal cones
