Angiographic findings in patients with postoperative soft tissue defects following total knee arthroplasty

2011 ◽  
Vol 19 (12) ◽  
pp. 2045-2049 ◽  
Author(s):  
Christian Herold ◽  
Andreas Steiert ◽  
Karsten Knobloch ◽  
Marc N. Busche ◽  
Mehmet A. Altintas ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Soft Tissue Defects ◽  
Total Knee ◽  
Tissue Defects ◽  
Angiographic Findings

scholarly journals Modified Medial Gastrocnemius Myocutaneous Flap Technique for Knee Joint Coverage after Total Knee Arthroplasty

2021 ◽  
Vol 17 (1) ◽  
pp. 67-71
Author(s):  
Dongseok Kim ◽  
Junhyung Kim ◽  
Woonhyeok Jeong ◽  
Taehee Jo ◽  
Jaehoon Choi
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Myocutaneous Flap ◽  
Perforator Flap ◽  
Medial Gastrocnemius ◽  
Soft Tissue Defects ◽  
Total Knee ◽  
Tissue Defects

While there are many reasons the medial gastrocnemius flap is often the favored treatment for soft tissue defects around the knee area, this flap has some disadvantages. Reduced volume at the distal part of the flap and a short reach complicate provision of sufficient coverage for soft tissue defects superior to the patella and the lateral knee. In order to overcome these shortcomings, we modified the typical surgical technique by combining a medial gastrocnemius muscle flap and a medial sural artery perforator flap. This approach was applied to four patients who had developed deep infections and skin and soft tissue defects around the knee joint after total knee arthroplasty. The surgeries were successful. Dead space was well-filled and wounds healed without complications in all patients. This modified medial gastrocnemius myocutaneous flap provides a new option for treating challenging skin and soft tissue defects caused by deep infection after total knee arthroplasty.

Reconstruction of soft tissue defects following total knee arthroplasty

The Knee ◽  
2002 ◽  
Vol 9 (3) ◽  
pp. 215-219 ◽  
Author(s):  
Adnan Menderes ◽  
Cenk Demirdover ◽  
Mustafa Yilmaz ◽  
Haluk Vayvada ◽  
Ali Barutcu
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Soft Tissue Defects ◽  
Total Knee ◽  
Tissue Defects

Patient Factors Associated with Failure of Flap Coverage Used during Revision Total Knee Arthroplasty

2017 ◽  
Vol 31 (08) ◽  
pp. 723-729
Author(s):  
Bishoy Gad ◽  
Joseph Styron ◽  
Mark Goergy ◽  
Alison Klika ◽  
Wael Barsoum ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Soft Tissue Defects ◽  
Patient Factors ◽  
Flap Coverage ◽  
History Of ◽  
Total Knee ◽  
Tissue Defects

AbstractRevision total knee arthroplasty (rTKA) is a challenging problem in the setting of soft tissue defects. The purpose of this study was to evaluate patients who underwent rTKA requiring flap coverage and determine patient factors that predisposed them to failure. Forty-three consecutive patients (mean follow-up, 46.5 months) who underwent rTKA requiring flap coverage were retrospectively reviewed between January 1, 2000 and December 31, 2010. Sixteen of 43 patients experienced failure requiring either flap revision (n = 2) or above the knee amputation (n = 14). Patients with heart failure (p = 0.008), cancer (p = 0.049), or infection with Klebsiella pneumoniae (p = 0.002) had greater rates of failure. Smoking (p = 0.287), diabetes (p = 0.631), and flap type (p = 0.634, p = 0.801) were not associated with increased failure. Mean survival was 46.4 months. Survival of patients with a history of cancer (34.3 months) was less (p = 0.033) than those without (49.2 months). Flap coverage in rTKA is a viable limb salvage option for patients with soft tissue defects; however, failure rates are much higher than in patients not requiring flap coverage.

scholarly journals Soft-tissue Defects After Total Knee Arthroplasty

2016 ◽  
Vol 24 (11) ◽  
pp. 769-779 ◽  
Author(s):  
Daniel A. Osei ◽  
Kelsey A. Rebehn ◽  
Martin I. Boyer
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Soft Tissue Defects ◽  
Total Knee ◽  
Tissue Defects

Soft Tissue Reconstruction for Deep Defects over a Complicated Total Knee Arthroplasty: A Systematic Review

2019 ◽  
Vol 33 (07) ◽  
pp. 732-744 ◽  
Author(s):  
Demetrius M. Coombs ◽  
Jessica Churchill ◽  
Paul Cartwright ◽  
Morad Chughtai ◽  
Assem A. Sultan ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Case Series ◽  
Soft Tissue Reconstruction ◽  
Soft Tissue Defects ◽  
Flap Coverage ◽  
Tissue Reconstruction ◽  
Total Knee ◽  
Tissue Defects

AbstractDeep soft tissue defects after complicated primary or revision total knee arthroplasty (TKA) can be devastating to the patient and technically challenging. The purpose of this review was to (1) discuss different methods used to provide coverage for deep defects of the knee following TKA, as well as to (2) report on their success rates. A comprehensive literature search was performed. Reports were only included if they (1) were case series, (2) were level III studies or above (including retrospective cohort studies and meta-analyses), (3) were in English, and (4) discussed the outcome of graft or flap coverage of soft tissue defects after total knee arthroplasty. A total of 28 case series and four retrospective comparative studies were retrieved. In 16 studies, 195 out of 241 patients who received gastrocnemius flaps (81%) experienced successful outcomes. In seven studies including 84 patients that underwent fasciocutaneous flap coverage, over 90% of patients experienced successful outcomes. In the four studies examining 144 patients with delayed versus prophylactic soft tissue reconstruction, up to 81% of patients experienced a successful outcome. Various factors must be taken into consideration when assessing full-thickness defects over a TKA and collaboration between plastic and orthopaedic surgeons is required to select the optimal approach.

scholarly journals Unilateral or bilateral V-Y fasciocutaneous flaps for the coverage of soft tissue defects following total knee arthroplasty

2010 ◽  
Vol 5 (1) ◽  
pp. 82 ◽  
Author(s):  
Konstantinos Papaioannou ◽  
Stergios Lallos ◽  
Andreas Mavrogenis ◽  
Elias Vasiliadis ◽  
Olga Savvidou ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Soft Tissue Defects ◽  
Fasciocutaneous Flaps ◽  
Total Knee ◽  
Tissue Defects

Is Soft Tissue Laxity Associated with Tissue Metal Concentrations after Total Knee Arthroplasty?

2018 ◽  
Vol 28 (2) ◽  
pp. 79-85
Author(s):  
Meredith Perkins ◽  
Julie Lowell ◽  
Christina Arnholt ◽  
Daniel MacDonald ◽  
Anita L. Kerkhof ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Metal Concentrations ◽  
Soft Tissue Laxity ◽  
Total Knee

scholarly journals Postoperative laxity of the lateral soft tissue is largely negligible in total knee arthroplasty for varus osteoarthritis

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110020
Author(s):  
Seikai Toyooka ◽  
Hironari Masuda ◽  
Nobuhiro Nishihara ◽  
Takashi Kobayashi ◽  
Wataru Miyamoto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Varus Deformity ◽  
Varus Knee ◽  
Before And After ◽  
Knee Deformity ◽  
Varus Stress ◽  
Total Knee

Purpose: To evaluate the integrity of lateral soft tissue in varus osteoarthritis knee by comparing the mechanical axis under varus stress during navigation-assisted total knee arthroplasty before and after compensating for a bone defect with the implant. Methods: Sixty-six knees that underwent total knee arthroplasty were investigated. The mechanical axis of the operated knee was evaluated under manual varus stress immediately after knee exposure and after navigation-assisted implantation. The correlation between each value of the mechanical axis and degree of preoperative varus deformity was compared by regression analysis. Results: The maximum mechanical axis under varus stress immediately after knee exposure increased in proportion to the degree of preoperative varus deformity. Moreover, the maximum mechanical axis under varus stress after implantation increased in proportion to the degree of preoperative varus deformity. Therefore, the severity of varus knee deformity leads to a progressive laxity of the lateral soft tissue. However, regression coefficients after implantation were much smaller than those measured immediately after knee exposure (0.99 vs 0.20). Based on the results of the regression formula, the postoperative laxity of the lateral soft tissue was negligible, provided that an appropriate thickness of the implant was compensated for the bone and cartilage defect in the medial compartment without changing the joint line. Conclusion: The severity of varus knee deformity leads to a progressive laxity of the lateral soft tissue. However, even if the degree of preoperative varus deformity is severe, most cases may not require additional procedures to address the residual lateral laxity.

scholarly journals Accuracy of soft tissue balancing in total knee arthroplasty using surgeon-defined assessment versus a gap-balancer or electronic sensor

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ran Zhao ◽  
Yanqing Liu ◽  
Hua Tian
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Sensor Data ◽  
Soft Tissue Balancing ◽  
Electronic Sensor ◽  
Prior Performance ◽  
Cumulative Summation ◽  
Total Knee ◽  
Sensitivity Specificity

Abstract Background Soft tissue balancing is essential for the success of total knee arthroplasty (TKA) and is mainly dependent on surgeon-defined assessment (SDA) or a gap-balancer (GB). However, an electronic sensor has been developed to objectively measure the gap pressure. This study aimed to evaluate the accuracy of soft tissue balancing using SDA and GB compared with a sensor. Methods Forty-eight patients undergoing TKA (60 knees) were prospectively enrolled. Soft tissue balancing was sequentially performed using SDA, a GB, and an electronic sensor. We compared the SDA, GB, and sensor data to calculate the sensitivity, specificity, and accuracy at 0°, 45°, 90°, and 120° flexion. Cumulative summation (CUSUM) analysis was performed to assess the surgeon’s performance during the sensor introductory phase. Results The sensitivity of SDA was 63.3%, 68.3%, 80.0%, and 80.0% at 0°, 45°, 90°, and 120°, respectively. The accuracy of the GB compared with sensor data was 76.7% and 71.7% at 0° and 90°, respectively. Cohen’s kappa coefficient for the accuracy of the GB was 0.406 at 0° (moderate agreement) and 0.227 at 90° (fair agreement). The CUSUM 0° line achieved good prior performance at case 45, CUSUM 90° and 120° showed a trend toward good prior performance, while CUSUM 45° reached poor prior performance at case 8. Conclusion SDA was a poor predictor of knee balance. GB improved the accuracy of soft tissue balancing, but was still less accurate than the sensor, particularly for unbalanced knees. SDA improved with ongoing use of the sensor, except at 45° flexion.

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