Patient Factors Associated with Failure of Flap Coverage Used during Revision Total Knee Arthroplasty
- 10 October 2017
- journal article
- research article
- Published by Georg Thieme Verlag KG in The Journal of Knee Surgery
- Vol. 31 (08), 723-729
- https://doi.org/10.1055/s-0037-1607060
Abstract
Background Revision total knee arthroplasty (rTKA) is a challenging problem in the setting of soft tissue defects. The purpose of this study was to evaluate patients who underwent rTKA requiring flap coverage and determine patient factors that predisposed them to failure. Methods Forty-three consecutive patients (mean follow-up, 46.5 months) who underwent rTKA requiring flap coverage were retrospectively reviewed between January 1, 2000 and December 31, 2010. Results Sixteen of 43 patients experienced failure requiring either flap revision (n = 2) or above the knee amputation (n = 14). Patients with heart failure (p = 0.008), cancer (p = 0.049), or infection with Klebsiella pneumoniae (p = 0.002) had greater rates of failure. Smoking (p = 0.287), diabetes (p = 0.631), and flap type (p = 0.634, p = 0.801) were not associated with increased failure. Mean survival was 46.4 months. Survival of patients with a history of cancer (34.3 months) was less (p = 0.033) than those without (49.2 months). Conclusion Flap coverage in rTKA is a viable limb salvage option for patients with soft tissue defects; however, failure rates are much higher than in patients not requiring flap coverage.Keywords
This publication has 30 references indexed in Scilit:
- Gastrocnemius flap reconstruction of soft-tissue defects following infected total knee replacementThe Bone & Joint Journal, 2013
- Deep-vein thrombosis after resection of musculoskeletal tumours of the lower limbThe Bone & Joint Journal, 2013
- Prophylactic Flap Reconstruction of the Knee Prior to Total Knee Arthroplasty in High-Risk PatientsAnnals of Plastic Surgery, 2011
- Unilateral or bilateral V-Y fasciocutaneous flaps for the coverage of soft tissue defects following total knee arthroplastyJournal of Orthopaedic Surgery and Research, 2010
- The use of muscle flaps in the salvage of infected exposed implants for internal fixationThe Journal of Bone and Joint Surgery. British volume, 2010
- Free myocutaneous latissimus dorsi flap transfer in total knee arthroplastyJournal of Plastic, Reconstructive & Aesthetic Surgery, 2009
- Reconstruction of Complete Knee Extensor Mechanism Loss with Gastrocnemius FlapsClinical Orthopaedics and Related Research, 2009
- Medial Gastrocnemius Flap Coverage for Treatment of Skin Necrosis after Total Knee ArthroplastyClinical Orthopaedics and Related Research, 2006
- Medial Gastrocnemius Muscle Flap in Limb-Sparing Surgery of Malignant Bone Tumors of the Proximal Tibia: Mid-Term Results in 25 PatientsAnnals of Plastic Surgery, 2003