Kniegelenksarthrodese – Lebensqualität und Vergleich der Methoden

Abstract

The number of total knee arthroplasties (TKA) has exploded in the industrialised countries in the last decade so it is inevitable that complications also rose. Persisting infection after exchange procedures sometimes cannot be cured other than by arthrodesis of the knee. Our aim was to study the results of this surgical intervention on the patients' quality of life. Between 2001 and 2007 90 patients, mean age 69 years (range 20-88), underwent an arthrodesis of the knee. External fixation, compression nail and plate osteosynthesis were used to perform the procedure. In a retrospective cohort study we analysed patients' data comparing the different methods. Sixty patients were asked to fill out two questionnaires, SF-36 score and WOMAC score. Additionally, five free verbalised questions were used to ask for the functional outcome and quality of life. According to the literature our results mark a change of practices over the years. In the last century the external fixation was the procedure of choice to stabilise the leg after implant-associated and post-traumatic infection. Since 2005 intramedullary compression nailing seems to have become superior (28 % - 100 %). Our retrospective cohort study points to the tendency for compression nail arthrodesis after failed and infected TKA. It seems that patients can be mobilised earlier, feel less pain and have a better quality of life with this procedure. These trends need confirmation by prospective randomised studies.