Knee Arthrodesis for Recurrent Periprosthetic Knee Infection.

Knee arthrodesis using a long intramedullary rod is a very effective and efficient method of fusion. With recurrent periprosthetic knee infections, metaphyseal bone loss is common and short knee-fusion rods may not provide adequate stability. Long rods for knee arthrodesis use the diaphysis for stability and have the additional advantage of being easily accessible for removal in the event of a recurrent infection with a well-healed fusion. Long intramedullary rods also provide the additional advantages of immediate weight-bearing. Immediate weight-bearing on the affected limb is critical because often these patients have been unable to bear weight preoperatively secondary to pain and infection. External fixation techniques are effective but come with pin-site problems. Pin-site problems are amplified in patients with obesity who have large soft-tissue envelopes, and the long intramedullary rod avoids pin problems in such patients. Antibiotic cement coating of the long intramedullary rod also provides local antibiotic delivery.