The salvage of knee-exposed prosthesis using neurofasciocutaneous sural flap

• Published in: Musculoskeletal surgery Vol. 94; no. 1; pp. 33 - 40
• Main Authors: Vaienti, L., Menozzi, A., Lonigro, J., Soresina, M., Ravasio, G.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01-05-2010; Springer; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Care and treatment; Female; Health aspects; Humans; Implants, Artificial; Infection; Joint surgery; Knee; Knee Prosthesis; Male; Medicine; Medicine & Public Health; Methicillin; Middle Aged; Original Article; Orthopedics; Prostheses; Prosthesis; Salvage; Skin; Surgical Flaps; Surgical Orthopedics; Surgical Wound Dehiscence - surgery; Wound healing; Wounds and injuries; Skin necrosis; Prosthetic exposure; Knee arthroplasty; Sural flap
• ISSN: 2035-5106; 2035-5114
• DOI: 10.1007/s12306-010-0063-x

Prosthetic exposure is a severe complication of total knee arthroplasty. Many factors are responsible for failed wound healing, and successful salvage of total knee arthroplasty requires early identification of infection, antecedent events related with wound healing failure, aggressive surgical debridement and early appropriate soft-tissue coverage with local skin, fasciocutaneous, muscle, neurocutaneous or perforator flaps. In this report, we present 15 cases of exposed knee prosthesis treated with island sural neurocutaneous flap. Follow-up showed favorable clinical outcomes: all flaps survived and only two cases of hematoma and one of aseptic phystula occurred. According to our results, the island neurofasciocutaneous sural flap represents a sensate reconstructive alternative for providing fine and dependable soft tissue for covering skin defects around the knee.