Conversion of a fused or ankylosed knee to a total-knee arthroplasty

Research output: Contribution to journalArticle

Abstract

Purpose of review: Recent reports have revisited the issue of conversion of an ankylosed knee to total-knee arthroplasty (TKA). Here, recent studies are reviewed and placed within the context of previous reports. Recent findings: An ankylosed or formally fused knee has been considered a contraindication for TKA by many and therefore conversion to TKA has been infrequently performed. From a position of ankylosis in flexion, conversion to a TKA achieved a high degree of patient acceptance and improvement in ambulation, but was complicated by a high wound complication rate. While the majority of conversions had most often been performed with a condylar constrained implant, a posterior stabilized implant without condylar constraint achieved equivalent results in the largest series to date (36 patients) without complications due to instability. An extensile approach with a V-Y quadricepsplasty or tibial tubercle osteotomy is recommended with an anticipated mild postoperative extensor lag and prolonged rehabilitation period required. The postoperative flexion arc ranged from 73° to 91°. Wound healing problems occur in up to 50% of cases and careful preoperative assessment of the soft-tissue envelope is imperative. Preoperative soft-tissue expansion has been suggested as one possible solution to this problem, but has not yet been reported upon. Summary: Conversion of a bony ankylosis or fusion to TKA can yield acceptable results; there is, however, a high complication rate and long-term outcomes are lacking. Patients must be carefully advised about expected outcomes and complications with specific attention to potential wound complications.

Original languageEnglish (US)
Pages (from-to)56-59
Number of pages4
JournalCurrent Opinion in Orthopaedics
Volume17
Issue number1
DOIs
StatePublished - Feb 2006
Externally publishedYes

Fingerprint

Knee Replacement Arthroplasties
Knee
Ankylosis
Tissue Expansion
Wounds and Injuries
Osteotomy
Wound Healing
Walking
Rehabilitation

Keywords

  • Knee ankylosis
  • Knee arthrodesis
  • Knee arthroplasty
  • Knee fusion

ASJC Scopus subject areas

  • Surgery

Cite this

Conversion of a fused or ankylosed knee to a total-knee arthroplasty. / Sterling, Robert Steven.

In: Current Opinion in Orthopaedics, Vol. 17, No. 1, 02.2006, p. 56-59.

Research output: Contribution to journalArticle

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