TOTAL KNEE ARTHROPLASTY IN A PREVIOUSLY ANKYLOSED OR ARTHRODESED KNEE

Few reports address the reconstructive challenge of total knee arthrop lasty after a surgically fused or ankylosed knee, The long term result s and complications of a large series of patients who have had their a nkylosed or arthrodesed knee converted to a total knee replacement wer e evaluated, Thirty-seven knees (35 patients, 28 female and 7 male) wi thout any motion in the knee were retrospectively reviewed in a multic enter study after total knee arthroplasty, The mean age was 53 years, and the average length of followup was 90 months, The results at follo wup showed an average 7 degrees lack of extension and 62 degrees flexi on, Complications included 24% short term complications and 35% major complications with a 14% infection rate, The total complication rate w as 57%, A satisfactory outcome (no pain and an unlimited ambulation di stance) was obtained in only 10 patients (29%), Patients with a satisf actory outcome had an average age of 45, and postoperative knee flexio n of 87 degrees, significantly different from those with an unsatisfac tory outcome, There was no relationship between results and the angle at which the knee was ankylosed preoperatively. This analysis indicate s that although success in reconstructing a previously ankylosed or ar throdesed knee is possible, the lack of consistent adequate motion and the complication rate may suggest that the surgeon reconsider the ris ks and benefits of this difficult procedure.