Treatment of Soft Tissue Defects after TKA using Saphenous Neurocutaneous Island Flaps

ABSTRACT

PURPOSE: The purpose of this study was to evaluate clinical outcomes in patients receiving saphenous neurocutaneous island flaps for reconstruction of soft tissue defects after total knee arthroplasty (TKA). MATERIALS AND METHODS: Four patients (2 men, 2 women mean age 61 years) with post-TKA soft tissue defects were treated with saphenous neurocutaneous island flaps between November 2001 and August 2007. The mean follow-up period was 3.5 years. Initial diagnoses were traumatic arthritis, rheumatoid arthritis, arthritis due to previous osteomyelitis, and tuberculous arthritis. One patient developed deep infection after TKA, so revision TKA with Nexgen(R) LPS (Legacy(R) posterior stabilized) was performed after soft tissue reconstruction. One soft tissue defect developed after TKA with Nexgen(R) LPS due to long-term steroid use for rheumatoid arthritis. Two cases occurred after placement of Nexgen(R) LCCK (Legacy(R) constrained condylar knee). Two cases developed secondary to diabetes mellitus and tuberculous arthritis. Soft tissue defects were located over the patella (1 case), patellar tendon (1 case), and medial side of the knee (2 cases). The flaps ranged in size from 3x4 cm to 8x5 cm. All flaps were proximally based. RESULTS: All flaps survived completely. The postoperative range of motion was between 3degrees and 100degrees. CONCLUSION: Because saphenous neurocutaneous island flaps are well matched with local tissue and are tough, thin, pliable and sensate, they are an ideal option for reconstruction of soft tissue defects after TKA.