• Carl Neuerburg, Ralf Bieger, Sebastian Jung, Thomas Kappe, Heiko Reichel, and Ralf Decking.
• Department of Orthopaedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany.
• Arch Orthop Trauma Surg. 2012 Aug 1;132(8):1183-9.

IntroductionFailed total knee replacement with compromised bone and soft-tissues can be challenging. In these situations, arthrodesis remains a treatment option of a limb-saving procedure.MethodsWe investigated the outcome of treatment with an intramedullary cemented knee arthrodesis nail implanted in 22 consecutive patients with forlorn situations after failed total knee replacement.ResultsThere were three major complications due to re-infection and two minor complications due to wound-healing disturbances that healed with the implant retained after an average follow-up of 3.4 years. Clinical examination, Short Form-36 and Oxford knee scores revealed low pain levels, safe implant anchorage, and improved stability of the knee, whilst autonomous mobility utilizing walking aids was still possible.ConclusionBridging knee arthrodesis with an intramedullary nail is a valuable salvage procedure with acceptable clinical results. As recurring infection remains the most challenging complication, regular clinical and radiological follow-up examinations are necessary following implant-related knee arthrodesis to allow timely intervention in case of loosening.

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