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J Am Acad Orthop Surg, Vol 14, No 3, March 2006, 154-163.
© 2006 the American Academy of Orthopaedic Surgeons
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Knee Arthrodesis

James H. MacDonald, MD, Sanjeev Agarwal, FRCS (Orth), Matthew P. Lorei, MD, Norman A. Johanson, MD and Andrew A. Freiberg, MD

Dr. MacDonald is in private practice in Annapolis, MD. Dr. Agarwal is Orthopaedic Surgeon, Leeds Orthopaedic Program, Leeds General Infirmary, Leeds, UK. Dr. Lorei is in private practice in Bryn Mawr, PA. Dr. Johanson is Chair, Orthopaedic Surgery, Drexel College of Medicine, Philadelphia, PA. Dr. Freiberg is Chief, Arthroplasty Service, Massachusetts General Hospital, Boston, MA.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. MacDonald, Dr. Agarwal, Dr. Lorei, and Dr. Johanson. Dr. Freiberg or the department with which he is affiliated serves as a consultant to or is an employee of Zimmer.

Reprint requests: Dr. MacDonald, Orthopaedic and Sports Medicine Center, 108 Forbes Street, Annapolis, MD 21401.

Arthrodesis is one of the last options available to obtain a stable, painless knee in a patient with a damaged knee joint that is not amenable to reconstructive measures. Common indications for knee arthrodesis include failed total knee arthroplasty, periarticular tumor, posttraumatic arthritis, and chronic sepsis. The primary contraindications to knee fusion are bilateral involvement or an ipsilateral hip arthrodesis. A variety of techniques has been described, including external fixation, internal fixation by compression plates, intramedullary fixation through the knee with a modular nail, and antegrade nailing through the piriformis fossa. Allograft or autograft may be necessary to restore lost bone stock or to augment fusion. For the carefully selected patient with realistic expectations, knee arthrodesis may relieve pain and obviate the need for additional surgery or extensive postoperative rehabilitation.






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Copyright © 2006 by the American Academy of Orthopaedic Surgeons.