Limb salvage of infected knee reconstructions for cancer with staged revision and free tissue transfer Journal Article
| Authors: | Manoso, M. W.; Boland, P. J.; Healey, J. H.; Cordeiro, P. G. |
| Article Title: | Limb salvage of infected knee reconstructions for cancer with staged revision and free tissue transfer |
| Abstract: | Periprosthetic infections of oncologic reconstructions have an amputation rate between 37% (1) and 87% (2). Eleven patients with an infected knee reconstruction following limb salvage surgery for cancer were treated with the staged protocol. All patients underwent prosthetic removal and implantation of an antibiotic-impregnated cement spacer, IV antibiotic therapy, repeat debridement and spacer change, and delayed prosthetic reconstruction and free tissue transfer.At the time of reconstruction, the median bone defect was 185 mm. The mean soft tissue defect was 112 cm. Coverage was obtained with a free musculocutaneous flap. All limbs were spared without amputation or flap loss. The mean functional outcome as measured by the Musculoskeletal Tumor Society lower extremity score was 23 of 30.Infections of large prosthetic reconstructions about the knee can be salvaged successfully with repetitive debridement, staged prosthetic reimplantation, and free tissue transfer. Free tissue transfer improves the soft tissue envelope and allows restoration of joint motion. Level of Evidence: Case Series. Level IV. Copyright © 2006 by Lippincott Williams & Wilkins. |
| Keywords: | osteosarcoma; adult; clinical article; treatment outcome; bone neoplasms; antibiotic agent; antibiotic therapy; cancer surgery; debridement; functional assessment; limb salvage; reconstructive surgical procedures; retrospective studies; transplantation, homologous; salvage therapy; surgical flaps; follow-up studies; infection; recurrent infection; prosthesis-related infections; postoperative complication; reoperation; ciprofloxacin; scoring system; knee; knee function; postoperative infection; staphylococcus aureus; staphylococcal infections; leiomyosarcoma; malignant fibrous histiocytoma; rhabdomyosarcoma; synovial sarcoma; free tissue graft; prosthesis; soft tissue defect; arthroplasty, replacement, knee; skin transplantation; bone cancer; muscle, skeletal; giant cell tumor; free flap; cefalexin; infection rate; tissue defect; knee disease; knee prosthesis; peroneus nerve paralysis; staphylococcus epidermidis |
| Journal Title: | Annals of Plastic Surgery |
| Volume: | 56 |
| Issue: | 5 |
| ISSN: | 0148-7043 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2006-05-01 |
| Start Page: | 532 |
| End Page: | 535 |
| Language: | English |
| DOI: | 10.1097/01.sap.0000203990.08414.ad |
| PUBMED: | 16641630 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 12" - "Export Date: 4 June 2012" - "CODEN: APCSD" - "Source: Scopus" |
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