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Journal ArticleDOI

Gastrocnemius flap reconstruction of soft-tissue defects following infected total knee replacement

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TLDR
A gastrocnemius flap is rotated over an infected total knee replacement defect during the first-stage of a revision procedure, which facilitates wound healing and the safe introduction of a prosthesis at the second stage.
Abstract
A soft-tissue defect over an infected total knee replacement (TKR) presents a difficult technical problem that can be treated with a gastrocnemius flap, which is rotated over the defect during the first-stage of a revision procedure. This facilitates wound healing and the safe introduction of a prosthesis at the second stage. We describe the outcome at a mean follow-up of 4.5 years (1 to 10) in 24 patients with an infected TKR who underwent this procedure. A total of 22 (92%) eventually obtained a satisfactory result. The mean Knee Society score improved from 53 pre-operatively to 103 at the latest follow-up (p < 0.001). The mean Western Ontario and McMaster Universities osteoarthritis index and Short-Form 12 score also improved significantly (p This form of treatment can be used reliably and safely to treat many of these complex cases where control of infection, retention of the components and acceptable functional recovery are the primary goals. Cite this article: Bone Joint J 2013;95-B:1217–21.

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Journal ArticleDOI

Soft Tissue Reconstruction and Flap Coverage for Revision Total Knee Arthroplasty

TL;DR: Understanding the advantages and pitfalls of each reconstructive option helps to guide treatment and avoid repeated operations and potentially devastating consequences such as knee arthrodesis or amputation.
Journal ArticleDOI

Patellar complications following total knee arthroplasty: a review of the current literature

TL;DR: It is concluded that patellar complications in total knee arthroplasty are common and have significant implications for the functional outcome of total knee AROs, and primary prevention is crucial.
Journal ArticleDOI

What Factors Influence the Success of Medial Gastrocnemius Flaps in the Treatment of Infected TKAs

TL;DR: Gastrocnemius flaps were used to address difficult soft tissue defects in this series, in the presence of deep infections; the high proportion of patients experiencing persistent or recurrent infections reflects the case complexity and not necessarily a problem with the flaps.
Journal ArticleDOI

Perforator-based propeller flaps reliability in upper extremity soft tissue reconstruction: a systematic review:

TL;DR: Perforator-based propeller flaps appear to be an interesting procedure for covering soft tissue defects involving the upper extremities, even for large defects, but the procedure requires experience and close monitoring.
Journal ArticleDOI

Soft-Tissue Reconstruction of the Complicated Knee Arthroplasty: Principles and Predictors of Salvage.

TL;DR: In revision total knee arthroplasty, prompt soft-tissue reconstruction improves the likelihood of success, and protracted surgical courses and contamination increase failure and amputations.
References
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Journal ArticleDOI

A 12-Item Short-Form Health Survey: Construction of Scales and Preliminary Tests of Reliability and Validity

TL;DR: Twenty cross-sectional and longitudinal tests of empirical validity previously published for the 36-item short-form scales and summary measures were replicated for the 12-item Physical Component Summary and the12-item Mental Component Summary, including comparisons between patient groups known to differ or to change in terms of the presence and seriousness of physical and mental conditions.
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Rationale of the Knee Society clinical rating system.

TL;DR: A new total knee rating system has been developed by The Knee Society to provide an up-to-date more stringent evaluation form and eliminates the problem of declining knee scores associated with patient infirmity.
Journal ArticleDOI

Clinical definition of independent myocutaneous vascular territories.

TL;DR: The vascular territories of 13 clinical myocutaneous flaps are defined, and possible uses of them are described, which may significantly alter the traditional approaches to flap designs and repairs.
Journal ArticleDOI

The versatile gastrocnemius myocutaneous flap.

TL;DR: The medial and lateral gastrocnemius myocutaneous flaps are described and this flap has supplanted the cross-leg flap for most reconstructions in the lower extremity.
Journal ArticleDOI

Above-the-knee amputation after a total knee replacement: prevalence, etiology, and functional outcome.

TL;DR: The overall prevalence of amputation after total knee arthroplasty at the tertiary care center was 0.36%, and the functional outcome after amputation performed above a total knee replacement is poor.
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