Limb salvage of infected knee reconstructions for cancer with staged revision and free tissue transfer

Annals of Plastic Surgery
Mark W ManosoP G Cordeiro

Abstract

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. Case Series. Level IV.

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Citations

Dec 17, 2010·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Alfredo Schiavone PanniMarzia Salgarello
Jun 19, 2010·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Takeshi MoriiKazuhiko Satomi
Nov 29, 2015·The Orthopedic Clinics of North America·John S Groundland, Odion Binitie
Feb 9, 2011·Annals of Plastic Surgery·William J CaseyAnthony A Smith
Aug 19, 2016·Plastic and Reconstructive Surgery·Jonathan I Leckenby, Adriaan O Grobbelaar
Jun 2, 2020·The Bone & Joint Journal·Gwo-Chin LeeStephen J Kovach
Jan 20, 2011·International Journal of Immunopathology and Pharmacology·C GraciC Fabbriciani
May 15, 2020·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Nicholas NucciDavid Wilson
Jul 3, 2010·The Journal of Bone and Joint Surgery. American Volume·C TiengoR De Caro
Jun 15, 2011·JBJS Essential Surgical Techniques·C TiengoR De Caro

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