Knee arthrodesis using the Ilizarov technique
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Arthrodesis of the knee without or with simultaneous lengthening.
Severe degenerative osteoarthritis in younger patients.
Neuropathic joint with bone loss and/or ligamentous instability.
Failed total knee arthroplasty.
Absolute: extensive osteomyelitis.
Relative: severe bone deficiency.
In elderly patients a simultaneous limb lengthening constitutes a relative contraindication.
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.
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.
Key WordsKnee arthrodesis Failed total knee arthroplasty Ilizarov technique
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