The application of hemicircular external fixator for knee joint arthrodesis with tuberculosis
CENG Wei-Na, ZHOU Zong-Ke, YANG Jing, CHEN Ban, KANG Feng-De, FEI Fu-Xin
Chinese Journal of Clinical Anatomy ›› 2012, Vol. 30 ›› Issue (6) : 698-700.
The application of hemicircular external fixator for knee joint arthrodesis with tuberculosis
Objective To discuss the efficacy and complications of hemicircular external fixator for joint fusion of the knee with tuberculosis. Medthods A total of 8 patients with late total knee tuberculosis treated by hemicircular external fixator were retrospectively analyzed between February 2007 and January 2009. 6 men and 2 women were investigated, with the average age of 35.4 years (28～40 years), and the average duration of disease of 3.1 years (9 months to 5.1 years). An anterior median incision was performed for all patients, then followed by the fusing of knee joint in functional position using hemicircular external fixator after complete debridement, taking osseous fusion as the end point of observation. Regular chemotherapy was applied post-operation for 18 months. Results Osseous fusion were achieved in all 8 patients post-operation, with the mean fusion period of 20.5 weeks(16～24 weeks), the length of affected limb of 4.9cm (3 cm～5 cm) shorter than the unaffected limb post-operation, the mean knee joint valgus angle of 5.2°( 4°～7°), and the mean knee joint flexion angle of 15.3°（10°～20°）. No patient had significant rotational deformity. There was no incision infection, nonunion, delayed union, external fixation failure happened, however, 3 patients appeared pin infection. Conclusions Hemicircular external fixator is an effective method to treat late total knee tuberculosis.
Knee / Tuberculosis / Arthrodesis / Hemicircular external fixator
[1] Lidder S, Lang K, Haroon M，et al. Tuberculosis of the knee
[J]. Orthop Rev, 2009, 1(2):e24.
[2] Bierwagen U, Walter G, Hoffmann R. Knee arthrodesis--quality of life and comparison of methods
[J]. Z Orthop Unfall, 2010, 148(5): 566- 572.
[3] Lai KA, Shen WJ, Yang CY. Arthrodesis with a short huckstep nail as a salvage procedure for failed total knee arthroplasty
[J]. J Bone Joint Surg Am, 1998, 80(3): 380-388.
[4] Puranen J, Kortelainen P, Jalovaara P. Arthrodesis of the knee with intramedullary nail ?xation
[J]. J Bone Joint Surg Am, 1990, 72(3): 433-442.
[5] Vlasak R, Gearen PF, Petty W. Knee arthrodesis in the treatment of failed total knee replacement
[J]. Clin Orthop Relat Res, 1995, 321: 138-144.
[6] Nichols SJ, Landon GC, Tullos HS. Arthrodesis with dual plates after failed total knee arthroplasty
[J]. J Bone Joint Surg Am, 1991, 73(7): 1020-1024.
[7] Lim HC, Bae JH, Hur CR, et al. Arthrodesis of the knee using cannulated screws
[J]. J Bone Joint Surg Br, 2009, 91(2): 180-184.
[8] Moeckel BH, Patterson BM, Inglis AE, et al. Ankle arthrodesis. A comparison of internal and external fixation
[J]. Clin Orthop Relat Res, 1991, 268: 78- 83.
[9] Rand JA, Bryan RS, Chao ES. Failed total knee arthroplasty treated by arthrodesis of the knee using the Ace-Fischer apparatus
[J]. J Bone Joint Surg Am, 1987, 69(1): 39-45.
[10]Manzotti A, Pullen C, Deromedis B, et al. Knee arthrodesis after infected total knee arthroplasty using the Ilizarov method
[J]. Clin Orthop Relat Res, 2001, 389:143-149.
[11] 徐明球，李起鸿，曾宪政，等. 膝关节切除加半环槽式外固定器治疗全膝关节结核(附27例报告)
[J].解放军医学杂志, 1989, 6(14): 376-377.
[12] Conway JD, Mont MA, Bezwada HP. Arthrodesis of the Knee
[J]. J Bone Joint Surg Am, 2004, 86(4):835-848.
[13] Manzotti A, Pullen C, Deromedis B, et al. Knee arthrodesis after infected total knee arthroplasty using the Ilizarov method
[J]. Clin Orthop Relat Res, 2001, 389:143-149.
[14] Cross AR, Lewis DD, Murphy ST, et al.Effects of ring diameter and wire tension on the axial biomechanics of four ring circular external fixator constructs
[J]. Am J Vet Res，2001, 62(7): 1025-1030.
[15]Gasser B, Boman B, Wyder D, et al. Stiffness characteristics of the circular Ilizarov device as opposed to conventional external fixators
[J]. J Biomech Eng, 1990, 112(1): 15-21.
[16]Calhoun JH, Li F, Bauford WL, et al.Rigidity of half-pins for the Ilizarov external fixator
[J]. Bull Hosp J Dis , 1992, 52(1): 21-26.
[17]Moroni A, Heikkila J, Magyar G, et al. Fixation strength and pin tract infection of hydroxyapatite-coated tapered pins
[J]. Clin Orthop Relat Res，2001, 388: 209-217.
[18]Gasser B, Boman B, Wyder D, et al. Stiffness characteristics of the circular Ilizarov device as opposed to conventional external fixators
[J]. J Biomech Eng, 1990，112(1): 15-21.
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