Comparative Analysis of Knee Joint Fusion with Long Locking Nail and Ilizarov Apparatus in Patients with Deep Infection after Arthroplasty

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Abstract

Relevance. Deep infection after knee arthroplasty requires radical surgical treatment of the infection site, removal of endoprosthesis components, and an antimicrobial spacer placement. If revision knee arthroplasty is impossible, the «gold standard» for this kind of patients is knee joint arthrodesis. The purpose of the study was the comparative analysis of knee joint fusion by external and internal fixation. Materials and Methods. The analysis of 60 cases of knee arthrodesis was carried out. The patients were divided into two groups with 30 patients in each. In the first group, knee arthrodesis was performed with long locking nail, in the second group — with external ring fixation. We compared the groups by intraoperative and drainage blood loss, the inpatient treatment duration, the terms of fusion and complications registered. The patients quality of life was evaluated using the SF-36 questionnaire before surgery, for the periods of 3, 6, and 12 months after the surgery. Results. The comparison of two methods of knee arthrodesis showed that blood loss in the internal fixation compared with external one, was 2.03 times more, the duration of inpatient treatment was 1.4 times less, and the total number of complications was 4.4 times less. However, the complications that affected the treatment outcome in long nail group were 1.5 times more. The differences in the average time of ankylosis formation were not statistically significant (p<0.05). The functional results of the treatment in 3 months after surgery in the group with internal fixation were much better. In 6 months after surgery the quality of life had no significant differences. In 12 months follow-up the indices in both groups were the same. Conclusion. The results of our study suggests us to think, knee joint arthrodesis by long fusion nail should be prefereble. If the nail insertion is technically impossible, and there is the high risk of deep infection recurrence, the external osteosynthesis should be used.

About the authors

L. N. Solomin

Vreden National Medical Research Center of Traumatology and Orthopedics; St. Petersburg State University

Email: fake@neicon.ru
ORCID iD: 0000-0003-3705-3280

Leonid N. Solomin – Dr. Sci. (Med.), Professor, Leading Researcher, Vreden National Medical Research Center of Traumatology and Orthopedics; Professor of the Surgery Chair Medical Faculty, St. Petersburg State University

St. Petersburg

Russian Federation

E. A. Shchepkina

Vreden National Medical Research Center of Traumatology and Orthopedics; Pavlov First St. Petersburg State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0001-6132-0305

Elena A. Shchepkina — Cand. Sci. (Med.), Senior Researcher, Vreden National Medical Research Center of Traumatology and Orthopedics; Associate Professor, Department of Traumatology and Orthopedics, Pavlov First St. Petersburg State Medical University

St. Petersburg

Russian Federation

K. L. Korchagin

Vreden National Medical Research Center of Traumatology and Orthopedics

Author for correspondence.
Email: korchagin.konstantin@gmail.com
ORCID iD: 0000-0001-8354-1950

Konstantin L. Korchagin — Cand. Sci. (Med.), Researcher Assistant

St. Petersburg

Russian Federation

F. K. Sabirov

Vreden National Medical Research Center of Traumatology and Orthopedics

Email: fake@neicon.ru
ORCID iD: 0000-0002-0307-0771

Fanil K. Sabirov — Cand. Sci. (Med.), Associate Professor, Department of Traumatology and Orthopedics

St. Petersburg,

Russian Federation

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