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Wound complications in total knee arthroplasty. Which flap is to be used? With or without retention of prosthesis?

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of our review paper is to present a possible algorithm of treatment of knee periprosthetic soft tissue defects, relative to their extent and depth. Different management of exposed total joints is also proposed, depending on the presence or loss of deep infection and on the timing of infection itself.

Methods

In accordance with literature and the experience of senior knee surgeon, the incidence and risk factors, and possible treatment options of wound complications following total knee arthroplasty have been throughly analyzed.

Results

There is much controversy regarding the optimal management of wound necrosis around a total knee. Local wound care, debridement, and fasciocutaneous, muscle and perforator flaps have been differently used. Muscle coverage remains the standard to which all other flaps should be compared, especially in infected wounds. Perforator flaps have recently represented a true revolution in the soft tissue reconstruction around the knee, with peculiar advantages due to their low donor morbidity and long pedicles.

Conclusion

When wound complications occur, prompt management is mandatory. An algorithm for treatment of wound defects is presented, available for both primary and revision knee replacement.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Science for Health, University of Molise, Via Francesco De Sanctis, Campobasso, Italy

    Alfredo Schiavone Panni, Michele Vasso & Simone Cerciello

  2. Department of Plastic Surgery, Catholic University of “Sacro Cuore”, Largo Francesco Vito 8, Rome, Italy

    Marzia Salgarello

  3. Casa di Cura San Luca, via Teano, 8/A, 00177, Rome, Italy

    Michele Vasso

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  1. Alfredo Schiavone Panni
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  2. Michele Vasso
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  3. Simone Cerciello
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  4. Marzia Salgarello
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Correspondence to Michele Vasso.

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Panni, A.S., Vasso, M., Cerciello, S. et al. Wound complications in total knee arthroplasty. Which flap is to be used? With or without retention of prosthesis?. Knee Surg Sports Traumatol Arthrosc 19, 1060–1068 (2011). https://doi.org/10.1007/s00167-010-1328-5

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