Long-term results of total knee arthroplasty after the use of soft tissue expanders.

The success of total knee arthroplasty can be jeopardized by poor wound healing. In the current study, the results of knee arthroplasty after soft tissue expansion were reviewed retrospectively in 27 patients (29 knees) at risk for problematic healing. The incidence of wound complications was recorded for all patients after the expansion procedure and the arthroplasty. A Knee Society score also was calculated at the latest evaluation. Minor wound complications occurred after 21% (six of 29) of the tissue expansion procedures and after 18% (five of 28) of the subsequent arthroplasties. One major wound complication occurred during tissue expansion necessitating abandonment of the planned arthroplasty. No major wound complications occurred in those patients who underwent knee arthroplasty. At an average followup of 34.4 months, the average Knee Society score was 83.7 points. The results of the current study show that the technique of soft tissue expansion before total knee arthroplasty in patients at high risk for wound healing problems can successfully prevent catastrophic wound complications after the arthroplasty procedure and can avoid the need for disfiguring soft tissue reconstructions.