Arch Plast Surg 2017 Mar 15;44(2):124-135. Epub 2017 Mar 15.
Department of Plastic Surgery, Georgetown University Hospital, Washington, DC, USA.
Download full-text PDF
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
Wounds 2018 Jul 30. Epub 2018 Jul 30.
Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC.
Introduction: Wound breakdown following total knee arthroplasty (TKA) increases the risk of device exposure, infection, and major amputation. Although a variety of options to facilitate coverage of compromised knee joint prostheses exist, the relative safety, efficacy, and functional impact of each has not been determined.
Objective: This study aims to identify those perioperative factors that influence reconstructive and functional outcomes in patients with periprosthetic TKA defects. 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