Arch Plast Surg 2017 Mar 15;44(2):124-135. Epub 2017 Mar 15.
Department of Plastic Surgery, Georgetown University Hospital, Washington, DC, USA.
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Clin Orthop Relat Res 2016 Mar 16;474(3):752-63. Epub 2015 Nov 16.
Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West Harrison Street, Suite 300, Chicago, IL, 60612, USA.
Background: Soft tissue defects after TKA are a potentially devastating complication. Medial gastrocnemius flaps occasionally are used to provide soft tissue coverage, most commonly with a periprosthetic joint infection.
Questions/purposes: We asked: (1) What were the rates of persistent or recurrent infection, implant survivorship, flap-related complications, and reoperation for patients who underwent medial gastrocnemius flap reconstruction for soft tissue coverage after TKA? (2) What were the Knee Society clinical and functional scores for patients who underwent medial gastrocnemius flap reconstruction for soft tissue defects after TKA? (3) What were the risk factors for failure of medial gastrocnemius flap reconstruction after TKA, with failure defined as recurrent or new periprosthetic joint infection or inability to reimplant the TKA prosthesis?
Methods: Between 2003 and 2011, four surgeons at one institution performed 31 medial gastrocnemius flaps for soft tissue coverage over an infected TKA. Read More
Plast Reconstr Surg 2016 Jan;137(1):177e-186e
Cleveland, Ohio From the Departments of Plastic Surgery and Orthopaedic Surgery, Cleveland Clinic.
Background: Insufficient soft-tissue coverage following total knee arthroplasty jeopardizes prosthesis retention and may lead to significant complications. The aim of this study was to evaluate the natural history of total knee arthroplasty following flap reconstruction of soft-tissue defects.
Methods: A retrospective review of patients treated with flaps after failed total knee arthroplasty between 1998 and 2013 was conducted. Read More
Ann Plast Surg 2016 May;76 Suppl 3:S213-5
From the Division of Plastic Surgery, Stanford University, Stanford, CA.
Introduction: Plastic surgeons are often asked to assist with the reconstruction of lower extremity wounds. These patients many times require free tissue transfer for coverage given paucity of soft tissue. Anecdotally, many orthopedic surgeons prefer muscle coverage--particularly in the setting of potentially infected bone. Read More
Plast Reconstr Surg 2015 Mar;135(3):895-902
Bethesda and Baltimore, Md.; Pittsburgh, Pa.; and Fort Belvoir, Va. From Walter Reed National Military Medical Center; Uniformed Services University of Health Sciences; the Johns Hopkins University School of Medicine; the University of Pittsburgh Medical Center; Fort Belvoir Community Hospital; and The Ohio State University Wexner Medical Center.
Background: War trauma patients who have sustained extremity trauma often exhibit extensive zones of injury with multiple concomitant injuries that can contribute to limited coverage options. Thus, flap availability and choice can become critical in the reconstruction algorithm of these severely traumatized patients. The authors' purpose was to analyze the outcomes of muscle and fasciocutaneous flaps during their extremity reconstructive experience to determine which option had better flap and limb salvage outcomes. Read More