Cementless modular intramedullary nail without bone-on-bone fusion as a salvage procedure in chronically infected total knee prosthesis: long-term results

Int Orthop. 2014 Feb;38(2):413-8. doi: 10.1007/s00264-013-2232-7. Epub 2013 Dec 14.

Abstract

Purpose: Our purpose was to evaluate long-term results of two-stage cementless intramedullary nailing without achieving bone-to-bone fusion for treating chronically infected total knee arthroplasty (TKA).

Methods: Thirty-eight patients treated according to the same protocol were retrospectively evaluated for clinical, functional, laboratory and radiological outcomes.

Results: Spacer exchange was necessary for infection persistence in one case. At a minimum two year follow-up, 34 patients (89.5%) showed no infection recurrence; among these 34 patients, 29 (85.3%) reported no or moderate pain [visual analogue scale (VAS) ≤3]; mild to moderate handicap (Lequesne Algofunctional Index < 7.5) was observed in 18 patients (52.9%). No patient underwent revision for aseptic loosening, and no nail breakage was observed.

Conclusions: Two-stage cementless intramedullary nailing without achieving bone-to-bone fusion is a viable option for treating chronically infected TKA in selected, complex cases.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthralgia / epidemiology
  • Arthroplasty, Replacement, Knee / instrumentation*
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Intramedullary / methods*
  • Humans
  • Incidence
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery*
  • Knee Prosthesis / microbiology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Prosthesis-Related Infections / surgery*
  • Radiography
  • Reoperation
  • Retrospective Studies
  • Salvage Therapy / methods*
  • Time Factors
  • Treatment Outcome