The role of pedicled or free fibular grafts in knee arthrodesis.

Arthrodesis of the knee can be facilitated by using a vascularized fibular graft if a large skeletal defect encompasses the knee joint or if conventional attempts at fusion have been unsuccessful. Solitary or double fibular grafts incorporated as part of a free tissue transfer or an ipsilateral pedicled flap rotated proximally about the knee are acceptable alternatives. Either version requires the technical expertise well known to reconstructive microsurgeons, as emphasized in this review, as a familiarity with this donor site and the nuances of graft elevation are essential for success.