Limb salvage of infected knee reconstructions for cancer with staged revision and free tissue transfer. Academic Article uri icon

Overview

abstract

  • UNLABELLED: Periprosthetic infections of oncologic reconstructions have an amputation rate between 37% and 87%. Eleven patients with an infected knee reconstruction following limb salvage surgery for cancer were treated with the staged protocol. All patients underwent prosthetic removal and implantation of an antibiotic-impregnated cement spacer, i.v. antibiotic therapy, repeat debridement and spacer change, and delayed prosthetic reconstruction and free tissue transfer. At the time of reconstruction, the median bone defect was 185 mm. The mean soft tissue defect was 112 cm2. Coverage was obtained with a free musculocutaneous flap. All limbs were spared without amputation or flap loss. The mean functional outcome as measured by the Musculoskeletal Tumor Society lower extremity score was 23 of 30. Infections of large prosthetic reconstructions about the knee can be salvaged successfully with repetitive debridement, staged prosthetic reimplantation, and free tissue transfer. Free tissue transfer improves the soft tissue envelope and allows restoration of joint motion. LEVEL OF EVIDENCE: Case Series. Level IV.

publication date

  • May 1, 2006

Research

keywords

  • Arthroplasty, Replacement, Knee
  • Knee Prosthesis
  • Muscle, Skeletal
  • Prosthesis-Related Infections
  • Salvage Therapy
  • Skin Transplantation
  • Surgical Flaps

Identity

Scopus Document Identifier

  • 33745662818

Digital Object Identifier (DOI)

  • 10.1097/01.sap.0000203990.08414.ad

PubMed ID

  • 16641630

Additional Document Info

volume

  • 56

issue

  • 5