Arthrodesis of the Knee with a Huckstep Nail Following the Treatment Failure of an Infected Total Knee Arthroplasty

ABSTRACT

We performed knee arthrodesis with a Huckstep nail in 4 patients that had failed in controlling infection after TKA. The purpose of this study is to introduce our surgical methods and report our clinical results. We retrospectively reviewed 4 patients who underwent knee arthrodesis with a Huckstep nail after the treatment failure of infection following TKA from 2003 to 2007. Mean age was 73 years (70~79 years). All patients had type II diabetes and hypertension. From primary TKA to knee arthrodesis with a Huckstep nail, patients underwent 3.2 operations (3~4 times) on average including removal of implant, synovectomy, antibiotic cement insertion, and revisional TKA. Allo-bone grafting was performed additionally in all cases to minimize lower limb shortening. Patients were evaluated clinically, hematologically and radiologically. The mean duration of follow-up was 20.2 months (12~36 months). All patients showed bony union radiologically within one year. There was no migration or loosening of a nail and screws. Limb length discrepancy was 3 cm on average. Although 1 patient complained ambulatory pain, all patients returned to ambulation without evidence of infection recurrence. Arthrodesis of the knee with a Huckstep nail for patients who had failed in controlling infection after TKA was considered effective treatment option.