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Knee joint reconstruction after hemiarticular resection using pedicled patella and vascularized fibular graft
Author(s) -
ElGammal Tarek A.,
ElSayed Amr,
Kotb Mohamed M.,
Saleh Waleed Riad,
Ragheb Yasser Farouk
Publication year - 2010
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.20796
Subject(s) - medicine , surgery , patella , avascular necrosis , tibia , fibula , knee joint , femur , range of motion , articular surface , femoral head
Abstract Between 1999 and 2005, seven patients had resection of tumors around the knee joint that involved half of the articular surface of the femoral or tibial side. Average age of the patients was 28 years (range, 14–40). Tumor pathology was giant cell tumor in four patients, osteoblastoma in two, and benign fibrous histocytoma in one patient. Two patients had recurrent tumors. The tumor was located in the distal femur in five patients and in the proximal tibia in the remaining two. The ipsilateral patella pedicled on the infrapatellar fat pad was used to substitute the resected articular surface and a vascularized fibula osteoseptocutaneous flap was used to reconstruct the metaphyseal defect. Average follow‐up period was 6.5 years (range, 3.5–10 years). All flaps survived. Average time to bone union was 3.5 months (range, 3–4 months), and average time to full weight‐bearing was 5 months (range, 4–6 months). No radiological signs of avascular necrosis of the patella were observed in any patient. Two patients required secondary procedures for correction of instability. One patient had local recurrence. At final follow‐up, the median range of knee motion was from 10° to 100°. The average Knee Society Score (KSS) was 76 points (range; 50–85 points), and the average KSS functional score was 76.6 points (range, 70–90 points). In conclusion, the procedure is a reliable option for after resection of tumors that involve half the articular surface of the femur or the tibia. © 2010 Wiley‐Liss, Inc. Microsurgery 30:603–607, 2010.