Abstract
Background Knee joint infections with pronounced joint destruction, soft tissue and bone involvement
are serious diseases in which not only the joint but also the entire extremity are
directly endangered. What results can be achieved with the Ilizarov external fixator
for septic knee arthrodesis?
Patients and Methods Between 2005 and 2017, 13 patients (4 women and 9 men, mean age 46 years) with acute
joint and concomitant bone and soft-tissue infections were treated with Ilizarov knee
joint arthrodesis. In addition to demographic data, the time spent in the fixator,
major and minor complications were retrospectively evaluated.
Results The average time spent in the Ilizarov external fixator was 27 weeks (min. 13, max.
68). Arthrodesis and infection repair were primarily achieved in 12 out of 13 patients.
In one patient, a delayed healing of the arthrodesis zone could be cured by iliac
crest bone grafting, so that eventually a bony knee arthrodesis was achieved in all
patients. Pin infects as a minor complication during the time spent in the fixator
were common and could be treated by stab incision and antibiotics. Major complications
occurred in 3 cases (2 femoral fractures peri-implant, 1 nonunion in the arthrodesis
area), which were treated by dilatation of the Ilizarov external fixator and finally
plate osteosynthesis or by resection of the pseudarthrosis and iliac crest bone grafting.
Conclusion The knee joint arthrodesis with the Ilizarov external fixator is a salvage procedure
for limb preservation in fulminant knee joint and concomitant soft tissue infections.
The advantages lie in the possibility of osteosynthesis in the acute infection and/or
chronic osteomyelitis and the direct full load capacity. Disadvantages are long and
complicated treatment times in the fixator with limited patient comfort.
Key words
Ilizarov external fixator - knee joint infection - salvage procedure
