Garcia-Lopez Ignacio, Aguayo Miguel Anguel, Cuevas Antonio, Navarro Pablo, Prieto Cristobal, Carpintero Pedro
University Hospital Reina Sofia, Cordoba, Spain.
Acta Orthop Belg. 2008 Dec;74(6):809-15.
We reviewed 20 patients who had undergone one-stage (7 cases) or two-stage (13 cases) knee arthrodesis using the Vari-Wall intramedullary nail, as a salvage operation following infection of a total knee arthroplasty. The procedure was followed by systemic antibiotic administration and early rehabilitation. Intraoperative microbiological cultures were taken. The average period of follow-up was 20 months. Solid union was achieved in 80%; mean time to fusion was 9 months. There was no recurrence of infection. The average limb length discrepancy was 2.45 cm. A walking aid was needed by 95% of the patients. The complication rate was 30% including 4 pseudarthroses, one intraoperative fracture and one peroneal nerve palsy. The Vari-Wall intramedullary nail is a good option when an arthrodesis is indicated for salvage of an infected total knee arthroplasty. It can be performed in one or two stages depending on several factors such as microbiologic culture results. It achieved good pain relief and acceptable functional results in this study.
我们回顾了20例患者，他们接受了一期（7例）或二期（13例）膝关节融合术，使用Vari-Wall髓内钉，作为全膝关节置换术后感染的挽救手术。术后进行了全身抗生素治疗和早期康复。术中进行了微生物培养。平均随访时间为20个月。80%实现了牢固愈合；平均融合时间为9个月。无感染复发。平均肢体长度差异为2.45厘米。95%的患者需要辅助行走工具。并发症发生率为30%，包括4例假关节、1例术中骨折和1例腓总神经麻痹。当需要进行关节融合术以挽救感染的全膝关节置换术时，Vari-Wall髓内钉是一个不错的选择。根据微生物培养结果等多种因素，可进行一期或二期手术。在本研究中，它实现了良好的疼痛缓解和可接受的功能结果。
