Operative management and outcome of complex wounds following total knee arthroplasty

Maurice Y. Nahabedian, Michael A. Mont, Joseph C. Orlando, Ronald E. Delanois, David S. Hungerford

Research output: Contribution to journalArticlepeer-review


This study describes the treatment protocol for and the outcome of the management of complex wounds around total knee replacements. An analysis of 28 patients (29 knees) with complex defects who had surgery between January 1, 1986, and July 30, 1996, was performed. A specific management protocol was applied to each knee on the basis of the size and depth of the wound, the presence of infection, and the quality of soft tissue. Primary treatment included local wound care, debridement, and skin grafting or coverage with a fasciocutaneous flap, pedicled muscle flap, or free muscle transfer. Postoperatively, knees were evaluated using the Knee Society objective score. Successful salvage of the lower extremity was obtained in 28 knees (97 percent) and of the knee prosthesis in 24 of 29 knees (83 percent). Secondary plastic surgery procedures were necessary in five knees (17 percent), and secondary orthopedic procedures were necessary in four knees (14 percent). Successful salvage of total knee arthroplasty in the presence of a complex wound requires early identification of infection, aggressive irrigation and debridement, and early appropriate soft-tissue coverage. The use of our proposed algorithm will facilitate management of these complex wounds.

Original languageEnglish (US)
Pages (from-to)1688-1697
Number of pages10
JournalPlastic and reconstructive surgery
Issue number6
StatePublished - Nov 1 1999

ASJC Scopus subject areas

  • Surgery


Dive into the research topics of 'Operative management and outcome of complex wounds following total knee arthroplasty'. Together they form a unique fingerprint.

Cite this