Knee joint arthrodesis in non-specific purulent osteoarthritis using external fixation device
In case of failure of conservative treatment in patients with nonspecific purulent osteoarthritis (NPOA) different surgical techniques can be used, including knee arthrodesis. Today various external fixators (EFD) for the joint arthrodesis are widely used.
Objective:to evaluate the results of surgical treatment of knee joint NPOA using the combined device of transosseous fixation.
Methods: it is proposed to use incomplete rings (¾ of circumference) reduce limb weight action on EFD elements. It is provided a mechanical testing of osteosynthesis rigidity in the case of developed EDF compared with ring pin-wire device in operated 24 patients (19 men and 5 women, age 24 to 76 years) with knee NPOA. Follow-up was 1, 3, 6 and 12 months.
Results: indicators of osteosynthesis rigidity in the case of the modified EFD and pin-wire external device had insignificant difference, which allowed to apply it for joint arthrodesis without losing the strength of fixation. Ankylosis obtained in 21 (95.5%) patients. The average term of fixation was (3.5 ± 0.5) month, the mean limb shortening — (2.0 ± 0.5) cm. Persistent halt of inflammation obtained in 22 patients, full weight-bearing recovery — in 21 (95.5 %). Quality of life improved in all patients. The average data of visual analogue scale (VAS) decreased from 8 (before surgery) to 3.1 (after).Conclusions: transosseous osteosynthesis in the treatment of patients with nonspecific purulent osteoarthritis of the knee joint is currently the treatment of choice. Used one-step arthrodesis technique of the knee joint with purulent osteoarthritis using modified EFD allowed to earlier patients ambulation, contributed to inhibition of inflammatory processes and weight-bearing recovery.
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