Knee arthrodesis with the Ilizarov external fixator as treatment for septic failure of knee arthroplasty

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Abstract
Background The authors report the results of femoral–tibial fusion with an Ilizarov circular external fixator following septic loosening of knee prosthesis. Materials and methods The series included 17 patients with a mean age of 62.9 years, treated from 1990 to 2007 with femoral–tibial fusion. The Cierny–Mader classification was used for clinical and anatomopathological evaluation; the Engh classification was used to assess the bone defect. Surgical treatment differed according to these criteria. Results Healing was achieved in 13 out of 17 patients at the first surgical attempt in a mean time of 9.3 months. Mean follow-up was 30 months. Of the four complications, two patients had an intolerance to the external fixator that led to its early removal, and the other two had a septic intrarticular nonunion. Conclusions The Ilizarov circular external fixator is a very reliable fixation system due to its low cost, versatility, stability under load, and low risk of septic dissemination. Nevertheless, an appropriate patient selection and a good surgeon’s experience are necessary.

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