Simultaneous Free Flap Transfer in Total Knee Arthroplasty in Case of Insufficient Soft Tissue Prior to Prosthetic Implantation: Indications and Results

摘要

Background: he purpose of this paper is to show our personal experience with simultaneous free flap transfer in total knee arthroplasty in case of insufficient soft tissue prior to prosthetic implantation. Material and Methods: In retrospective clinical study 11 patients who underwent simultaneous flap surgery in the context of total knee arthroplasty because of insufficient soft tissue prior to implantation are reviewed. In 10 patients a free myo-cutaneous latissimus dorsi flap and in 1 patient a pedicled medial gastrocnemius muscle flap in combination with a split thickness skin graft were carried out. In a retrospective clinical study, the following criteria were examined: 1) etiology of soft tissue defect, 2) number of previous operations, 3) Status of the knee extensor mechanism judged as complete, partial, missing, 4) primary wound healing, 5) complications and 6) active range of motion. Result: Primary wound healing could be achieved in 6 patients with a free myocutaneous latissimus dorsi flap and in the only patient with a pedicled medial gastrocnemius muscle flap. After free latissimus dorsi transfer skin breakdown of the recipient site occurred in 4 patients. Secondary skin grafting was carried out in 3 patients and a fascio-cutaneous flap in the remaining. Average active range of motion prior to combined surgery was for extension/flexion 0-7-27?.