MUSCLE FLAPS IN TOTAL KNEE ARTHROPLASTY

The results of 12 patients who had been treated with muscle flap cover age for compromised soft tissues associated with total knee arthroplas ty were studied. Five latissimus dorsi free flaps, 6 medial gastrocnem ius rotational flaps, and 2 rectus abdominis free flaps were done in 1 2 knees. The authors used and classified 3 types of muscle flaps: (1) prophylactic soft tissue coverage, done before definitive reconstructi on; (2) treating muscle flap for infected prostheses with deficient so ft tissue coverage; and (3) salvage muscle flap for wound dehiscence o r necrosis in the immediate postoperative period. These patients were observed for an average of 4.1 years (range, 1-8 years). The wound was revascularized successfully in 100% of the knees. The prosthesis was preserved in 83% of the knees. Recurrent infection occurred in 3 patie nts. Treating muscle flaps are least likely to result in an overall su ccessful reconstruction because these flaps are used in knees with chr onic infection. Prophylactic flaps and salvage muscle flaps provide th e soft tissue coverage necessary to allow successful reconstruction in the appropriate circumstances.