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Roberts Conference

Roberts Conference. July 21, 2005. History. 64 year old male 6 yrs s/p Left Knee Arthrodesis following TKA Significantly short on affected side 2 falls resulting in Hip Fractures Successful TKA on Right. Operative Planning. Patient Requesting TKA ESR, CRP and WBC all Normal

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Roberts Conference

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  1. Roberts Conference July 21, 2005

  2. History • 64 year old male • 6 yrs s/p Left Knee Arthrodesis following TKA • Significantly short on affected side • 2 falls resulting in Hip Fractures • Successful TKA on Right

  3. Operative Planning • Patient Requesting TKA • ESR, CRP and WBC all Normal • No Swelling or external evidence of infection

  4. Conversion Athrodesis to TKA • Kreder et. al: 18 knees  28% failure (infection, component failure) • Cameron and Hu: 17 knees  53% failure (tibial component loosening, ligamentous laxity, quad rupture, wound breakdown, repeat athrodesis) • Kim et. al: 30 knees  53% failure; mean flexion 75 deg, 9 deg extension deficit • Henkel et. al: 7 knees  29% failure; 71% re-operation; most with increased pain on walking • Warner: Three phase “Judet quadricepsplasty” to mobilize extensor mechanism.

  5. Holden DL, Jackson DW. Considerations in total knee arthroplasty following previous knee fusion. Clin Orthop.1988; 227:223 -8. • Kreder HJ, Williams JI, Jaglal S, Axcell T, Stephen D. A population study in the Province of Ontario of the complications after conversion of hip or knee arthrodesis to total joint replacement. Can J Surg.1999; 42:433 -9. • Bradley GW, Freeman MA, Albrektsson BE. Total prosthetic replacement of ankylosed knees. J Arthroplasty. 1987;2:179 -83. • Cameron HU. Role of total knee replacement in failed knee fusions. Can J Surg.1987; 30:25 -7. • Naranja RJ Jr, Lotke PA, Pagnano MW, Hanssen AD. Total knee arthroplasty in a previously ankylosed or arthrodesed knee. Clin Orthop. 1996;331 : 234-7. • Henkel TR, Boldt JG, Drobny TK, Munzinger UK. Total knee arthroplasty after formal knee fusion using unconstrained and semiconstrained components: a report of 7 cases. J Arthroplasty.2001; 16:768 -76. • Cameron HU, Hu C. Results of total knee arthroplasty following takedown of formal knee fusion. J Arthroplasty. 1996;11:732 -7. • Warner JP. The Judet quadricepsplasty for management of severe posttraumatic extension contracture of the knee. A report of a bilateral case and review of the literature. Clin Orthop.1990; 256:169 -73.

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