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Outcome following soft tissue coverage with a medial gastrocnemius flap of an exposed or infected total knee arthroplasty
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Hand Surgery.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Hand Surgery.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Hand Surgery.ORCID iD: 0000-0003-1868-292x
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Hand Surgery.
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2023 (English)In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 112, no 3, p. 173-179Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Soft tissue defects or periprosthetic infections after total knee arthroplasty (TKA) are severe complications that may lead to loss of the arthroplasty or the limb. Reconstructions with medial gastrocnemius flaps (MGF) are occasionally used to provide soft tissue coverage around the knee.

AIMS: The study aimed to establish the rate of implant survivorship after MGF reconstruction for soft tissue coverage in the treatment of exposed or infected TKA and to establish functional outcome.

METHODS: A retrospective analysis was performed on all patients who received soft tissue coverage with an MGF of an exposed or infected TKA between 2000 and 2017 at the Department of Hand and Plastic Surgery at Umeå University Hospital. The outcomes were implant survivorship and patient-reported outcome measures (PROMs) using the five-level EQ-5D version and The Knee Injury and Osteoarthritis Outcome Score.

RESULTS: Forty-seven patients (mean age = 67 years, 30 women) were included. The mean time between flap coverage and follow-up was 6.7 (±3.4) years. Implant survivorship was observed in 28 of 47 (59.6%) patients at follow-up. Flap failure was rare, with only 3 of 47 (6.4%) cases. Of the 20 patients who answered the PROMs, 10 of 20 experienced moderate to severe pain or discomfort.

CONCLUSIONS: Due to unfavorable underlying conditions, MGF reconstruction after TKA is often associated with a compromised functional outcome. Because donor site morbidity is limited and flap failure is unusual, the procedure can be considered prophylactically in a small subset of patients with risk factors to prevent soft tissue defects and periprosthetic joint infection.

Place, publisher, year, edition, pages
Sage Publications, 2023. Vol. 112, no 3, p. 173-179
Keywords [en]
Medial gastrocnemius flap, functional outcome, total knee arthroplasty
National Category
Orthopaedics
Identifiers
URN: urn:nbn:se:umu:diva-209320DOI: 10.1177/14574969231175562PubMedID: 37264639Scopus ID: 2-s2.0-85162933116OAI: oai:DiVA.org:umu-209320DiVA, id: diva2:1763954
Available from: 2023-06-08 Created: 2023-06-08 Last updated: 2023-11-13Bibliographically approved

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Wiberg, RebeccaBackman, OlofEdmundsson, DavidMukka, Sebastian

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