Knee Arthrodesis: Salvage Procedure After Failed Total Knee Arthroplasty

With the increase in the aging population globally, there has been a proportional increase in total knee arthroplasty (TKA) procedures. Estimates show that by 2030, the number of TKA procedures will grow by more than 650% [2]. Furthermore, the demand for revision TKA following failed primary TKA is expected to grow by nearly 600% in the next 5 years [2–4]. As these numbers grow, there are also increased chances of clinicians needing to manage cases of multiple failed TKAs leading to an un reconstructible TKA [5]. This subset of patients offers significant challenges to the surgeon due to complexities involved with the decreased remaining native bone for revision surgery, poor skin condition, and managing patients’ expectations after the procedure. In these circumstances, knee arthrodesis (KA) can be a useful salvage option in restoring the weight-bearing ability of the patient, in addition to providing a stable extremity. The cumulative incidence of KA following failed TKA due to periprosthetic joint infection (PJI) is 0.26%, as per one reported study [6]. Clinicians need to be convinced regarding the benefit of KA, compared to other treatment options, including transfemoral amputations and above-knee amputations.