In certain cases of lower limb problems, the combined approach of Plastic and Orthopedic surgeons offers specific advantages. One stage operation, quicker recovery, less hospital stay and reduced cost is some to mention. We present our experience including both chronic and emergency cases that we applied the combined approach. The use of muscle flaps mainly, provided smooth postoperative course especially in patients that were at increased risk of skin necrosis due to previous operation scars or infection.

Using this approach cases such as revision knee arthroplasty or trauma had much better results

The preoperative recognition of this particular group of patients at increased risk and the planned combined intraoperative approach are the most important steps in order to avoid complications. Our choices were pedicle and free muscle flaps. We present our experience in treating patients following this regime with encouraging results overall

Purpose: The correlation of surgical wounds for total hip and knee replacements with the presentation or recurrence of skin disorders.

Materials-method: In 9 patients, 5 men and 4 women, operated for total knee replacement and 1 patient, a female, operated for total hip replacement, skin disorders appeared around their surgical wounds. The female patient with the THR sustained a herpes zoster in the operated buttock 8 months after surgery. 1 patient with leuke had an exaltation of symptoms the wounds of both operated knees. 6 patients, 2 men and 4 women, had increased growth of hair on both sides of the wound some months after the TKR, in contrast with the rest of their skin. 1 patient with psoriasis had increased local symptoms after a TKR compared with the non-operated side. Finally, 1 patient, 25 days after a TKR, sustained an exanthema around his wound.

Conclusion: Total joint replacement may rarely be the cause for the presentation or recurrence of skin disorders around the surgical wounds.