Summary
Objectives
Arthrodesis of the knee without or with simultaneous lengthening.
Indications
Severe degenerative osteoarthritis in younger patients.
Neuropathic joint with bone loss and/or ligamentous instability.
Failed total knee arthroplasty.
Contraindications
Absolute: extensive osteomyelitis.
Relative: severe bone deficiency.
In elderly patients a simultaneous limb lengthening constitutes a relative contraindication.
Surgical Technique
For primary arthrodesis: resection of articular cartilage and subchondral bone.
For aseptic loosening: removal of components and alignment of bone ends.
For infected total joint: 2-stage procedure.
In all instances obtain a slight flexion at the arthrodesis. Temporary fixation with crossed Kirschner wires. Application of Ilizarov frame and compression. For lengthening: Ilizarov distraction method.
Results
Between 1993 and 1996, 11 patients underwent an Ilizarov knee arthrodesis with an average follow-up interval of 35 months. Indications included: severe osteoarthritis, 2: ligament instability in spina bifida patient, 1; and failed total knee arthroplasty, 8. Three patients developed a pseudarthrosis, all were noted to have a severe bone loss. Two of these patients were fitted with an orthosis and the 3rd underwent a successful AO double plate fixation. Removal of wires on account of infection was needed twice. Average time to union was 4.5 months.
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Feibel, R.J., Guy, J. Knee arthrodesis using the Ilizarov technique. Orthop Traumatol 8, 117–132 (2000). https://doi.org/10.1007/BF03181128
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DOI: https://doi.org/10.1007/BF03181128