Prophylactic Free Flap for Chronic Lower-Extremity Soft-Tissue Defect Prior to Total Knee Arthroplasty

2013 ◽  
Vol 3 (3) ◽  
pp. e75
Author(s):  
Dane C. Hansen ◽  
Wong K. Moon ◽  
Sharat K. Kusuma
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Lower Extremity ◽  
Free Flap ◽  
Knee Arthroplasty ◽  
Soft Tissue Defect ◽  
Tissue Defect ◽  
Total Knee

Superior Lateral Genicular Artery Flap for Coverage of a Soft Tissue Defect after Total Knee Arthroplasty

2009 ◽  
Vol 25 (08) ◽  
pp. 479-482 ◽  
Author(s):  
Yasunori Taniguchi ◽  
Takashi Kitano ◽  
Takashi Shimoe ◽  
Yoshiki Asai ◽  
Munehito Yoshida
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Soft Tissue Defect ◽  
Tissue Defect ◽  
Genicular Artery ◽  
Total Knee

Long Term Outcomes of Total Knee Arthroplasty Following Soft Tissue Defect Reconstruction with Flaps

2015 ◽  
Vol 136 ◽  
pp. 15-16
Author(s):  
Grzegorz Kwiecien ◽  
Gregory Lamaris ◽  
Bahar Bassiri Gharb ◽  
Trevor Murray ◽  
Mark F. Hendrickson ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Soft Tissue Defect ◽  
Long Term Outcomes ◽  
Tissue Defect ◽  
Defect Reconstruction ◽  
Total Knee

Long-Term Outcomes of Total Knee Arthroplasty following Soft-Tissue Defect Reconstruction with Muscle and Fasciocutaneous Flaps

2016 ◽  
Vol 137 (1) ◽  
pp. 177e-186e ◽  
Author(s):  
Grzegorz J. Kwiecien ◽  
Gregory Lamaris ◽  
Bahar Bassiri Gharb ◽  
Trevor Murray ◽  
Mark F. Hendrickson ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Soft Tissue Defect ◽  
Long Term Outcomes ◽  
Fasciocutaneous Flaps ◽  
Tissue Defect ◽  
Defect Reconstruction ◽  
Total Knee

Attributes of Perforator Flaps for Prophylatic Soft Tissue Augmentation Prior to Definitive Total Knee Arthroplasty

2019 ◽  
Author(s):  
Saïd C. Azoury ◽  
John T. Stranix ◽  
Merisa Piper ◽  
Stephen J. Kovach ◽  
Geoffrey G. Hallock
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Free Flap ◽  
Knee Arthroplasty ◽  
Perforator Flap ◽  
Soft Tissue Augmentation ◽  
Perforator Flaps ◽  
Tissue Augmentation ◽  
Anterolateral Thigh ◽  
Total Knee

Abstract Background As our population ages, the demand for total knee arthroplasty (TKA) will dramatically increase to ensure an independent lifestyle with unimpeded and pain-free ambulation. Complications will be inevitable, especially in that patient with preexisting soft tissue deficits or extensive scarring in the knee region. Under these circumstances, prophylactic soft tissue augmentation should be strongly considered and be extremely beneficial. Methods A retrospective review of all TKA procedures at our institutions over the past two decades revealed seven patients who specifically had soft tissue augmentation prior to their definitive TKA. Each had a single perforator flap used to achieve this. In no cases was a muscle flap used for this purpose. Excluded were all patients who had a flap of any kind for coverage of an exposed prosthesis or to accomplish wound healing after the TKA. Results Seven perforator flaps were utilized in seven patients for soft tissue replacement prior to the ultimate TKA. For smaller defects in three patients, a local island medial sural artery perforator flap was used. For larger defects in four patients, an anterolateral thigh perforator free flap was necessary. All flaps were successful. The only complication was an implant infection after one anterolateral thigh free flap that required a revision arthroplasty that eventually allowed salvage. Unrestricted ambulation was possible in all patients except for one who had a preexisting contralateral below-knee amputation. Conclusion As the number of TKA procedures in the near future increases, prevention of the absolute number of complications becomes even more important. An awareness that any knee region suboptimal soft tissue base can lead to wound breakdown and then periprosthetic infection should alert all involved that prevention of this sequela can be best achieved by prior soft tissue augmentation. Preferably, this may be possible by capturing the assets of local and free perforator flaps.

Heterodigital Free Flap of Index Finger Amputee for Coverage of the Long Finger Soft Tissue Defect

2013 ◽  
Vol 22 (2) ◽  
pp. 82-85 ◽  
Author(s):  
So-Min Hwang ◽  
Jang Hyuk Kim ◽  
Hong-Il Kim ◽  
Yong-Hui Jung ◽  
Hyung-Do Kim
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Index Finger ◽  
Soft Tissue Defect ◽  
Tissue Defect

Is Soft Tissue Laxity Associated with Tissue Metal Concentrations after Total Knee Arthroplasty?

2018 ◽  
Vol 28 (2) ◽  
pp. 79-85
Author(s):  
Meredith Perkins ◽  
Julie Lowell ◽  
Christina Arnholt ◽  
Daniel MacDonald ◽  
Anita L. Kerkhof ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Metal Concentrations ◽  
Soft Tissue Laxity ◽  
Total Knee

scholarly journals Postoperative laxity of the lateral soft tissue is largely negligible in total knee arthroplasty for varus osteoarthritis

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110020
Author(s):  
Seikai Toyooka ◽  
Hironari Masuda ◽  
Nobuhiro Nishihara ◽  
Takashi Kobayashi ◽  
Wataru Miyamoto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Varus Deformity ◽  
Varus Knee ◽  
Before And After ◽  
Knee Deformity ◽  
Varus Stress ◽  
Total Knee

Purpose: To evaluate the integrity of lateral soft tissue in varus osteoarthritis knee by comparing the mechanical axis under varus stress during navigation-assisted total knee arthroplasty before and after compensating for a bone defect with the implant. Methods: Sixty-six knees that underwent total knee arthroplasty were investigated. The mechanical axis of the operated knee was evaluated under manual varus stress immediately after knee exposure and after navigation-assisted implantation. The correlation between each value of the mechanical axis and degree of preoperative varus deformity was compared by regression analysis. Results: The maximum mechanical axis under varus stress immediately after knee exposure increased in proportion to the degree of preoperative varus deformity. Moreover, the maximum mechanical axis under varus stress after implantation increased in proportion to the degree of preoperative varus deformity. Therefore, the severity of varus knee deformity leads to a progressive laxity of the lateral soft tissue. However, regression coefficients after implantation were much smaller than those measured immediately after knee exposure (0.99 vs 0.20). Based on the results of the regression formula, the postoperative laxity of the lateral soft tissue was negligible, provided that an appropriate thickness of the implant was compensated for the bone and cartilage defect in the medial compartment without changing the joint line. Conclusion: The severity of varus knee deformity leads to a progressive laxity of the lateral soft tissue. However, even if the degree of preoperative varus deformity is severe, most cases may not require additional procedures to address the residual lateral laxity.

scholarly journals Accuracy of soft tissue balancing in total knee arthroplasty using surgeon-defined assessment versus a gap-balancer or electronic sensor

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ran Zhao ◽  
Yanqing Liu ◽  
Hua Tian
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Sensor Data ◽  
Soft Tissue Balancing ◽  
Electronic Sensor ◽  
Prior Performance ◽  
Cumulative Summation ◽  
Total Knee ◽  
Sensitivity Specificity

Abstract Background Soft tissue balancing is essential for the success of total knee arthroplasty (TKA) and is mainly dependent on surgeon-defined assessment (SDA) or a gap-balancer (GB). However, an electronic sensor has been developed to objectively measure the gap pressure. This study aimed to evaluate the accuracy of soft tissue balancing using SDA and GB compared with a sensor. Methods Forty-eight patients undergoing TKA (60 knees) were prospectively enrolled. Soft tissue balancing was sequentially performed using SDA, a GB, and an electronic sensor. We compared the SDA, GB, and sensor data to calculate the sensitivity, specificity, and accuracy at 0°, 45°, 90°, and 120° flexion. Cumulative summation (CUSUM) analysis was performed to assess the surgeon’s performance during the sensor introductory phase. Results The sensitivity of SDA was 63.3%, 68.3%, 80.0%, and 80.0% at 0°, 45°, 90°, and 120°, respectively. The accuracy of the GB compared with sensor data was 76.7% and 71.7% at 0° and 90°, respectively. Cohen’s kappa coefficient for the accuracy of the GB was 0.406 at 0° (moderate agreement) and 0.227 at 90° (fair agreement). The CUSUM 0° line achieved good prior performance at case 45, CUSUM 90° and 120° showed a trend toward good prior performance, while CUSUM 45° reached poor prior performance at case 8. Conclusion SDA was a poor predictor of knee balance. GB improved the accuracy of soft tissue balancing, but was still less accurate than the sensor, particularly for unbalanced knees. SDA improved with ongoing use of the sensor, except at 45° flexion.

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