Salvage procedures for complex soft tissue defects of the knee

The management options for complex soft tissue defects about the knee are v aried, Limb threatening conditions such as exposure of joint prosthesis or bone requires stable coverage to avoid amputation. A study was conducted to review the authors' management protocol and experience with complex defect s about the knee. A retrospective analysis from 1986 to 1996 of 35 patients with complex defects about the knee was performed. Treatment options were based on the nature, size, location, and depth of the wound. A specific man agement protocol was applied for each patient. Treatments included local wo und care, debridement and skin graft, fasciocutaneous flap, pedicled muscle flap, and free muscle transfer, Postoperatively, patients were evaluated u sing Knee Society objective and functional scores and other instruments to measure outcome. Successful salvage of the lower extremity was obtained in 34 (97 %) patients. Salvage of the total knee prosthesis was obtained in 24 of 29 (83%) patients. Secondary plastic surgery procedures were necessary in eight (23 %) patients. Secondary orthopaedic procedures were necessary i n five (15%) patients. No patient required an amputation.