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General Orthopaedics

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Background

Infected total knee arthroplasties present in a variety of different clinical settings. With severe local compromise and draining sinus tract around the knee, after adequate debridement, the resultant patellectomy with need for free muscle transfer and split thickness skin graft for closure, usually results in loss of quadriceps function. This necessitates the need for drop lock brace. No good mechanisms are available for reconstruction of large anterior defects in total infected total knees where this occurs.

Questions

Can proximal placement of the knee joint with longer tibial segments aid in closure in patients with large anterior skin defects, and can this placement aid in quadriceps reconstruction to alleviate the need for drop lock braces while ambulating?