ABSTRACT
The authors describe the technique, devised by Juvara and modified by Merle d'Aubigné of resection-arthrodesis of the knee with fixation by medullary nailing and using massive bone grafts. They report 38 cases operated on for various conditions (20 giant-cell tumours, 7 chondro-sarcoma, 6 juxta-cortical sarcoma, 3 other types of sarcoma, one desmoid fibroma, one chondroma). The best results were obtained in cases in which surgical excision had been sufficiently wide and when very thick nails were used. The use of homografts increased the rate of infection. Resections of the lower and of the femur resulted in more complications than tibial resections. In femoral lesions, the part of the tibia that is transplanted should not be turned upside-down but should be mobilised upwards to provide better bone contact. The indications are discussed and compared with those of total replacement. The authors believe that, despite the number of complications, this technique is more practicable than total knee replacement.
