Abstract
The aim of this study was to demonstrate the effectiveness of a customised coupled arthrodesis nail.
Knee arthrodesis is now infrequently performed and is usually reserved as a salvage for infected Joint arthroplasty or occasionally for intractable pain. Many methods have been used. Recently locked intramedullary coupled nails have gained in popularity. To deal with all size combinations a large inventory is required. We wish to report our series using a customised implant and to compare the outcome with other methods of knee arthrodesis.
Nine patients underwent arthrodesis using this implant, six following infected arthroplasty, two for intractable anterior knee pain and following trauma. Comparison was made with 17 arthrodeses performed since 1993 using external fixation (8), plates (4), and long K-nails (5). Union was achieved in nine patients (100%) at a mean time of 10 months using the customised implant. There were no complications despite early weight-bearing. No further procedures were required. This contrasted with a union rate of 65% with a 76% complication rate using alternative techniques. Seventy six percent of this second group required a further operative procedure.
We conclude that a customised coupled intramedullary nail can give excellent stability allowing early weight-bearing, and results in a high union rate with minimal post-operative complications. The differences in need for further surgery and occurrence of complications were statistically significant (p< 0.001), and differences in in-patient stay and non-union rate were also significant (p< 0.05) using Fisher’s exact test.
The abstracts were prepared by Mr Roger Smith. Correspondence should be addressed to him c/o British Orthopaedic Association, Royal College of Surgeons, 35-42 Lindoln’s Inn Fields, London WC2A 3PN.
