Conversion of Formal Knee Fusion to Total Knee Arthroplasty

A solid fusion of a knee is still considered the most successful treatment for intractable pyogenic, tuberculous arthritis or varying arthritis. The indications for knee joint arthroplasty following solid fusion were certainly few and the procedure of total knee arthroplasty (TKA) in fused knee was technical demanding and high-risk of postoperative complications. We reported a 40-year-old male who had undergone right knee fusion 30 years previously because of knee trauma. We performed TKA via a medial parapatellar incision to follow the previous incision scar without performing V-Y quadricepsplasty. After 12 months' follow-up, no instability, skin necrosis or prosthesis loosening was found except persistent limitation of range of motion (ROM). The postoperative ROM was 0° to 30° and arthrofibrosis was diagnosed at the latest follow-up. The preoperative Hospital for Special Surgery Knee rating system was 57 and 69 postoperatively. Because such a complication was high, takedown of a formal knee fusion with TKA should be performed only in carefully selected cases with high motivation. Perioperative quadricepsplasty and aggressively postoperative rehabilitation were important to prevent such complication.

並列關鍵字

arthrofibrosis ； fused knee ； total knee arthroplasty (TKA) ； V-Y quadricepsplasty

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