Knee Arthrodesis Using Ilizarov Method with Autogenous Bone Graft Application in a Second-Stage Surgery: A Case Report of a Morbidly Obese and Diabetic Patient with a Septic Failure of Total Knee Arthroplasty

Abstract

Currently, the main indication for knee arthrodesis is septic failure of a total knee arthroplasty (TKA). Circular external fixation has shown good results, and it is a good option to treat these cases. We present a case of a morbidly obese female, 55 years old, with a chronic septic failure of TKA, submitted to a knee arthrodesis using the Ilizarov technique. In a second-stage surgery, the remaining bone defect was filled with autogenous iliac crest graft. A radiographic and clinical fusion was verified 3 and 5 months, respectively, after the primary surgery. Twelve months later, she is very satisfied with the surgery results, presenting a Visual Analog Scale score 1 and a stable and pain-free lower limb. The residual limb length discrepancy was 3 cm, and she walks with a shoe lift without external support. Our case emphasizes the importance of autogenous bone graft application in a second-stage surgery to a successful and fast knee arthrodesis using the Ilizarov method in patients with chronic septic failure of TKA and severe comorbidities.