Table 1.
Various methods of knee arthrodesis described in the literature.
| Reference | Arthrodesis Method | Publication | N | Complications | Outcomes | |
| 1 | Rothacker 1983 [72] | Hoffman External Fixator (Multiplanar pin insertion) |
Retrospective | 50 | Pin site infection (1/50, 0.5%) | Union 86.2% |
| 2 | Kinik 2009 [73] | Ilizarov bone transport | Case reports | 3 | Need for posteromedial release for equinovarus deformity (2/3, 66%) | Union 100% Acceptable alignment Bone transport of up to 22cm (mean=17.3) |
| 3 | Eralp 2008 [77] | Unilateral External Fixator | Retrospective | 11 | LLD 1.4cm (range 1-3) Pin tract infection (5/11, 45.4%) |
Union 100% Eradication of infection 100% Walk independently 100% |
| 4 | Kutscha-Lissberg 2006 [79] | Hybrid External Fixator | Prospective | 17 | Superficial pin tract infection (2/17, 11.76%) Painful wire, exchanged (1/17, 5.9%) Failed union (2/17, 11.76%) |
Eradication of infection (14/17, 82.3%) Independently mobile without walking aids in patients with isolated knee disorders (9/9, 100%) Pain Relief (17/17, 100%) |
| 5 | Oostenbroek 2001 [74] | Ilizarov External Fixation | Retrospective | 15 | Complications 80% Non-union (1/15, 6.66%) LLD 4cm (range 2 - 6) Pin tract infection (15/15, 100%) Pin tract infection requiring IV antibiotics and removal of infected pin (3/15, 20%) Peri-prosthetic fracture at time of implant removal (2/15, 13.33%) |
Union (14/15, 93.33%) Eradication of infection 100% |
| 6 | Gunes 2005 [75] | Circular External Fixator | Case report | 1 | Pin tract infection requiring oral antibiotics | Union 100% Complete eradication of infection 100% Independent weight bearing and walking without crutches |
| 7 | Ulstrup 2007 [76] | Sheffield Ring Fixator | Retrospective | 10 | Nonunion (4/10, 40%) Pin tract infection (7/10, 70%) |
Union (6/10, 60%) Eradication of infection 100% |
| 8 | Corona 2013 [78] | Monolateral External Fixator | Retrospective | 21 | Pain scores significantly higher in nonunion cases | Union (17/21, 81%) Eradication of infection (18/21, 86%) Worse functional outcomes in patients > 75 years. |
| 9 | Riouallon 2009 [80] | Combination of external fixator and Steinman pin | Retrospective | 6 | Complications (3/6, 50%) Hematoma requiring surgical evacuation (1/6, 16%) Peri-prosthetic fracture (1/6, 16%) Osteitis managed by surgical curettage (1/6, 16.66%) |
Union 100% Eradication of infection (5/6, 83%) Weight bearing at 2 - 3 months |
| 10 | De Vil 2008 [62] | Intramedullary nail | Retrospective | 15 | Persistent infection and nonunion (4/15, 26%) Amputation (3/15, 20%) Aseptic non-union (1/15, 6.66%) LLD 4.5cm (range 2.8 - 6.2) |
Union (11/15, 73%) Return to work (50%) |
| 12 | Putman 2013 [64] | Customized Modular Intramedullary Nail | Retrospective | 31 | Persistent infection requiring nail removal (3) and long term suppressive antibiotics (3) (6/31, 19.4%) LLD 1cm (range 0.5-3.4) |
|
| 13 | Rao 2009 [66] | Modular Cemented Intramedullary Nail | Retrospective | 7 | Recurrent infection requiring revision procedure (2/7, 28.6%) | Significant improvement of pain scores |
| 14 | Waldman 1999 [65] | Modular Intramedullary nail | Retrospective | 21 | Nonunion requiring repeat bone grafting (1/21, 4.7%) | Union (20/21, 95%) |
| 15 | Ellingsen 1994 [63] | Intramedullary nail | Retrospective | 18 | Complications (10/18, 55%) Nonunion (2/18, 11%) Prolonged operation (6 hours) Average blood replacement 2975 ml |
|
| 16 | Bargiotas 2006 | Intramedullary Nail | Retrospective | 12 | Nonunion (2/12, 16%) Recurrence of infection (2/12, 16%) AKA (1/12, 8.33%) LLD 5.5 cm |
Union (10/12, 83.33%) |
| 17 | Talmo 2007 [91] | Long Intramedullary Fusion Nail | Retrospective | 29 | Pain following complete fusion 62% Metal failure and implant breakage (2/29, 6.9%) Recurrent infection (3/29, 10.34%) |
Union (24/29, 83%) Independent mobility requiring a single walking aid (17/29, 58.6%) |
| 18 | Lai 1998 [69] | Short Huckstep Nail | Retrospective | 33 | Recurrent infection (1/33, 3%) | Union (30/33, 91%) |
| 19 | Lee 2012 [70] | Distraction with Huckstep Intramedullary Nail and Bone Graft (Autologous + Allograft) | Retrospective | 8 | LLD 1.1 cm | Union (8/8, 100%) Eradication of infection (8/8, 100%) |
| 20 | Fern 1989 [67] | Curved Kuntscher Nail | Prospective | 13 | Metalwork failure requiring removal and repeat fixation (1/13, 7.7%) Persistent wound discharge requiring metal removal (1/13, 7.7%) |
Not recorded |
| 21 | Iacono 2013 [85]. | Press-fit Modular Intramedullary Nail with Antibiotic Loaded Cement | Retrospective | 22 | LLD <1 cm Recurrent infection (3/22, 4.5%) |
Significant improvement in pain and function |
| 22 | Barsoum 2008 [71] | Wichita Fusion Nail | Retrospective | 7 | Complication rate 57% Persistent infection requiring rod removal (2/7, 28.5%) Atrophic nonunion (1/7, 14%) Permanent peroneal nerve palsy (1/7, 14%) |
Union (6/7, 86%) Pain Relief (5/7, 71%) Ambulation (6/7, 86%) |
| 23 | Nichols 1991 [88] | Dual Compression Plates | Retrospective | 11 | Femoral stress fracture (1/22, 4.5%) Persistent infection (1/22, 4.5%) |
Union (11/11, 100%) |
| 24 | Kuo 2005 [89] | Dual Plating with Locking Compression Plate (LCP) | Case reports | 3 | None reported | Union (3/3, 100%) Independent mobility using a single crutch (1) or walker (2) |
| 25 | Lim 2009 [90] | Cannulated Screws | Retrospective | 8 | Delayed union requiring bone graft (1/8, 12.5%) Wound necrosis requiring skin graft (1/8, 12.5%) LLD 3.1cm (range 1.1 - 6.5cm) |
Union (7/8, 87.5%) Eradication of infection (8/8, 100%) Independent mobility Pain and function improved |
| 26 | Bartlett 2011 [81] | Stanmore Knee Arthrodesis Prosthesis | Retrospective | 9 | Uncontrolled infection (1/9, 11%) Prosthetic fracture (1/9, 11%) |
Implant survivorship 90% Independent mobility 100% |
| 27 | Jung 2009 [83] | Computer Assisted Navigation and Ilizarov fixation | Case report | 1 | Not recorded | Not recorded |
| 28 | Bigliani 1983 [82] | Pulsing Electromagnetic Field with Various Methods of Fixation | Prospective | 20 | Not recorded | Union (85%) |