The Hip: Preservation, Replacement and Revision

Knee Arthrodesis



- See: Arthrodesis following TKR:

- PreOp Planning for Arthrodesis:

- Discussion:
    - arthrodesis provides potential of a painless, stable base of support but it does so at the expense of knee motion;
    - optimal position of arthrodesis:
           - slight valgus, 10 deg of external rotation, and 0-20 deg of flexion (knees that have been shortened due to previous arthroplasty 
                  should be fused in full extension);
           - valgus alignment with slight flexion easier to obtain with an external fixator than w/ IM nail;
                  - IM nails tend to cause 2-5 deg of varus;
    - note that if future total knee replacement is a consideration (fusion takedown and arthroplasty) then it is important that the patella not be 
           included in the fusion;
    - contra-indications:
           - bilateral knee disease;
           - ipsilateral ankle or hip disease;
           - severe segmental bone loss;
           - contralateral leg amputation;


- Techniques of Arthrodesis:
     - External Fixation:
     - Intramedullary Nailing Arthrodesis:
     - Plate Fixation:



- Complications:
    - non union:
            - most frequent complication of arthrodesis is non-union.
            - etiology of non-union includes bone loss, persistent infection, incomplete bone apposition, limb malalignment, and inadequate 
                  immobilization



Knee arthrodesis following total knee arthroplasty in rheumatoid arthritis.

Long-term evaluation of hip arthroplasty in patients with an ipsilateral knee arthrodesis.

Arthrodesis of the knee with a vascularized fibular rotatory graft.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, May 10, 2012 11:51 am