Knee arthrodesis after infected total knee arthroplasty using the Ilizarov method.

Numerous treatments have been proposed for infected total knee arthroplasty. In selected patients, a knee arthrodesis is a well-recognized salvage procedure. However, there are no reports in the literature discussing the treatment of infected total knee arthroplasty using the Ilizarov method. The authors reviewed their experience with this technique in infected total knee arthroplasty, presenting six patients (four women, two men) treated between 1992 and 1998. The average age was 56.6 years (range, 23-70 years) and the mean number of previous surgical procedures was seven (range, 4-10 procedures). From the time of frame removal, the patients were followed up for a mean of 34.2 months (range, 12.4-87.5 months). Full weight-bearing was allowed 1 week after surgery if half-pins were used and after a mean of 2.6 months if Kirschner wires were used. Of the five patients who have completed treatment, all have obtained a stable knee arthrodesis after a mean external fixation time of 6.8 months without additional surgical procedures or bracing. All of the patients were satisfied with the treatment. The authors recommend knee arthrodesis by the Ilizarov method for infected total knee arthroplasty, particularly in patients with extensive bone loss, significant limb shortening or axial deformity or both, active infection, or previous failed arthrodesis.