A Lagaras1, V Kontogeorgakos2, S Varitimidis1, K N Malizos1. 1. Department of Orthopedics, University Hospital of Larissa, Larissa, Greece. 2. First Department of Orthopedics, "ATTIKON" University General Hospital, Athens, Greece.
Abstract
PURPOSE: This retrospective case series assessed the results of a treatment protocol for patients with infected para-articular knee nonunions. The aim was to demonstrate that knee function and quality-of-life (QoL) can be improved. CASE SERIES: Between January 2001 and December 2011, eleven patients with septic proximal tibial nonunion and seven with septic distal femoral nonunion were managed at our institution. The treatment protocol included extensive debridement, skeletal stabilization, culture-specific antibiotic administration, and soft-tissue and bone-deficit reconstruction. Knee function was evaluated with the Knee Society Score (KSS) while the Knee injury and Osteoarthritis Outcome Score (KOOS) and SF-12 were used for QoL assessment at a mean follow-up of 37.2 (range: 12-149) months. Seventeen nonunions healed at a mean of 21.9 weeks. One patient needed above knee amputation. Knee Society function and knee scores were improved significantly, from 16.7 and 33.8, to 75.0 and 84.9 respectively (p <0.001). KOOS outcome and SF-12 physical and mental components scores confirmed the QoL improvement. CONCLUSIONS: Staged management can improve QoL and functional knee outcome. HIPPOKRATIA 2018, 22(4): 183-187. Copyright 2018, Hippokratio General Hospital of Thessaloniki.
PURPOSE: This retrospective case series assessed the results of a treatment protocol for patients with infected para-articular knee nonunions. The aim was to demonstrate that knee function and quality-of-life (QoL) can be improved. CASE SERIES: Between January 2001 and December 2011, eleven patients with septic proximal tibial nonunion and seven with septic distal femoral nonunion were managed at our institution. The treatment protocol included extensive debridement, skeletal stabilization, culture-specific antibiotic administration, and soft-tissue and bone-deficit reconstruction. Knee function was evaluated with the Knee Society Score (KSS) while the Knee injury and Osteoarthritis Outcome Score (KOOS) and SF-12 were used for QoL assessment at a mean follow-up of 37.2 (range: 12-149) months. Seventeen nonunions healed at a mean of 21.9 weeks. One patient needed above knee amputation. Knee Society function and knee scores were improved significantly, from 16.7 and 33.8, to 75.0 and 84.9 respectively (p <0.001). KOOS outcome and SF-12 physical and mental components scores confirmed the QoL improvement. CONCLUSIONS: Staged management can improve QoL and functional knee outcome. HIPPOKRATIA 2018, 22(4): 183-187. Copyright 2018, Hippokratio General Hospital of Thessaloniki.
Entities:
Keywords:
Nonunion; bone defect; circular frame; infection; knee; quality of life
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