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Knee arthrodesis as last resort for persistent knee joint infections: Comparison of extramedullary and intramedullary treatment

BACKGROUND: Knee joint arthrodesis is an established treatment for periprosthetic infections (PPI) providing stability and pain relief. In this study the outcome after arthrodesis of the knee joint for persistent infections was compared and evaluated depending on the surgical procedure (intramedulla...

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Autores principales: Zajonz, Dirk, Zimmerlich, Benedikt, Möbius, Robert, Edel, Melanie, Przybyl, Johanna, Höch, Andreas, Fakler, Johannes K. M., Roth, Andreas, Ghanem, Mohamed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Medizin 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925473/
https://www.ncbi.nlm.nih.gov/pubmed/32666143
http://dx.doi.org/10.1007/s00132-020-03939-z
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author Zajonz, Dirk
Zimmerlich, Benedikt
Möbius, Robert
Edel, Melanie
Przybyl, Johanna
Höch, Andreas
Fakler, Johannes K. M.
Roth, Andreas
Ghanem, Mohamed
author_facet Zajonz, Dirk
Zimmerlich, Benedikt
Möbius, Robert
Edel, Melanie
Przybyl, Johanna
Höch, Andreas
Fakler, Johannes K. M.
Roth, Andreas
Ghanem, Mohamed
author_sort Zajonz, Dirk
collection PubMed
description BACKGROUND: Knee joint arthrodesis is an established treatment for periprosthetic infections (PPI) providing stability and pain relief. In this study the outcome after arthrodesis of the knee joint for persistent infections was compared and evaluated depending on the surgical procedure (intramedullary vs. extramedullary). MATERIAL AND METHODS: In a retrospective case analysis, all patients who underwent knee joint arthrodesis between 1 January 2010 and 31 December 2016 were identified and divided into two groups: IMA and EMA. All patients were examined clinically and radiologically and the patient files were evaluated. In addition, the FIM score, the LEFS, the WHOQOL-BREF and NRS were evaluated. RESULTS: The median LEFS score for the IMA group was 26 points and in the EMA group 2 points (p = 0.03). The IMA patients showed a median pain scale at rest of 0 and during exercise of 2. The EMA group recorded a pain scale of 3 at rest and 5 during exercise (p = 0.28 at rest; p = 0.43 during exercise). In the IMA group the median postsurgical leg length difference was −2.0 cm and −2.5 cm in the EMA group (p = 0.31). At the end of the follow-up examinations, the FIM score of patients in the IMA group was 74.5 points and 22 points in the EMA group (p = 0.07). CONCLUSION: The study showed that no arthrodesis procedure is obviously superior with respect to the postoperative outcome. The IMA combines advantages especially in the early phase after surgery in terms of function as well as patient comfort and is therefore currently the procedure of choice. The attending physician should be familiar with the advantages and disadvantages of the various procedures in order to be able to make an individual decision and thus maximize the chance of treatment success.
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spelling pubmed-79254732021-03-19 Knee arthrodesis as last resort for persistent knee joint infections: Comparison of extramedullary and intramedullary treatment Zajonz, Dirk Zimmerlich, Benedikt Möbius, Robert Edel, Melanie Przybyl, Johanna Höch, Andreas Fakler, Johannes K. M. Roth, Andreas Ghanem, Mohamed Orthopade Originalien BACKGROUND: Knee joint arthrodesis is an established treatment for periprosthetic infections (PPI) providing stability and pain relief. In this study the outcome after arthrodesis of the knee joint for persistent infections was compared and evaluated depending on the surgical procedure (intramedullary vs. extramedullary). MATERIAL AND METHODS: In a retrospective case analysis, all patients who underwent knee joint arthrodesis between 1 January 2010 and 31 December 2016 were identified and divided into two groups: IMA and EMA. All patients were examined clinically and radiologically and the patient files were evaluated. In addition, the FIM score, the LEFS, the WHOQOL-BREF and NRS were evaluated. RESULTS: The median LEFS score for the IMA group was 26 points and in the EMA group 2 points (p = 0.03). The IMA patients showed a median pain scale at rest of 0 and during exercise of 2. The EMA group recorded a pain scale of 3 at rest and 5 during exercise (p = 0.28 at rest; p = 0.43 during exercise). In the IMA group the median postsurgical leg length difference was −2.0 cm and −2.5 cm in the EMA group (p = 0.31). At the end of the follow-up examinations, the FIM score of patients in the IMA group was 74.5 points and 22 points in the EMA group (p = 0.07). CONCLUSION: The study showed that no arthrodesis procedure is obviously superior with respect to the postoperative outcome. The IMA combines advantages especially in the early phase after surgery in terms of function as well as patient comfort and is therefore currently the procedure of choice. The attending physician should be familiar with the advantages and disadvantages of the various procedures in order to be able to make an individual decision and thus maximize the chance of treatment success. Springer Medizin 2020-07-14 2021 /pmc/articles/PMC7925473/ /pubmed/32666143 http://dx.doi.org/10.1007/s00132-020-03939-z Text en © The Author(s) 2020 Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Originalien
Zajonz, Dirk
Zimmerlich, Benedikt
Möbius, Robert
Edel, Melanie
Przybyl, Johanna
Höch, Andreas
Fakler, Johannes K. M.
Roth, Andreas
Ghanem, Mohamed
Knee arthrodesis as last resort for persistent knee joint infections: Comparison of extramedullary and intramedullary treatment
title Knee arthrodesis as last resort for persistent knee joint infections: Comparison of extramedullary and intramedullary treatment
title_full Knee arthrodesis as last resort for persistent knee joint infections: Comparison of extramedullary and intramedullary treatment
title_fullStr Knee arthrodesis as last resort for persistent knee joint infections: Comparison of extramedullary and intramedullary treatment
title_full_unstemmed Knee arthrodesis as last resort for persistent knee joint infections: Comparison of extramedullary and intramedullary treatment
title_short Knee arthrodesis as last resort for persistent knee joint infections: Comparison of extramedullary and intramedullary treatment
title_sort knee arthrodesis as last resort for persistent knee joint infections: comparison of extramedullary and intramedullary treatment
topic Originalien
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925473/
https://www.ncbi.nlm.nih.gov/pubmed/32666143
http://dx.doi.org/10.1007/s00132-020-03939-z
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