OBJECTIVE: To describe our early experience with a new technique for restoring destroyed knee joints to give reasonable functional results. DESIGN: Observational clinical trial. SETTING: Level-1-Trauma centre, Germany. SUBJECTS: 5 patients with large bone defects of the knee and loss of the extensor apparatus caused either by serious injury alone, or infection after serious injury. INTERVENTIONS: Transplantation of fresh and perfused knee joints with a vascular pedicle from multiorgan donors under immunosuppression. MAIN OUTCOME AND MEASURES: Ability to walk, need to remove one transplanted joint. RESULTS: Four patients are able to walk, the range of movement being from 50 degrees-120 degrees. The first patient additionally had to be provided with a total knee joint arthroplasty. In the third patient the graft became infected and had to be removed. She finally had an arthrodesis and bone lengthening by the Ilizarov technique. CONCLUSIONS: Transplantation of the knee joint may be an alternative to bone lengthening or amputation for patients with total loss of the extensor apparatus.
OBJECTIVE: To describe our early experience with a new technique for restoring destroyed knee joints to give reasonable functional results. DESIGN: Observational clinical trial. SETTING: Level-1-Trauma centre, Germany. SUBJECTS: 5 patients with large bone defects of the knee and loss of the extensor apparatus caused either by serious injury alone, or infection after serious injury. INTERVENTIONS: Transplantation of fresh and perfused knee joints with a vascular pedicle from multiorgan donors under immunosuppression. MAIN OUTCOME AND MEASURES: Ability to walk, need to remove one transplanted joint. RESULTS: Four patients are able to walk, the range of movement being from 50 degrees-120 degrees. The first patient additionally had to be provided with a total knee joint arthroplasty. In the third patient the graft became infected and had to be removed. She finally had an arthrodesis and bone lengthening by the Ilizarov technique. CONCLUSIONS: Transplantation of the knee joint may be an alternative to bone lengthening or amputation for patients with total loss of the extensor apparatus.
Authors: François Petit; Alicia B Minns; Jean-Michel Dubernard; Shehan Hettiaratchy; W P Andrew Lee Journal: Ann Surg Date: 2003-01 Impact factor: 12.969