Free antero-lateral thigh flap for total knee prosthesis coverage after infection complicating malignant tumour resection

Orthop Traumatol Surg Res. 2018 Sep;104(5):713-717. doi: 10.1016/j.otsr.2018.05.006. Epub 2018 Jun 19.

Abstract

Background: Infection is a common complication of major lower limb-sparing surgery with massive total knee prosthesis (MTKP) reconstruction after extensive tumour resection. When free tissue transfer is required to cover the prosthesis, musculo-cutaneous flaps are usually preferred based on proven efficacy when used in both one-stage and two-stage procedures. The use of a free fascio-cutaneous antero-lateral thigh (FC-ALT) flap in 3 patients with infected knee reconstructions is reported here.

Material and method: A retrospective study was performed of 3 patients in whom a free FC-ALT flap was used during a two-stage procedure to treat MTKP infection after femoral sarcoma resection.

Results: Free FC-ALT flap transfer and exchange arthroplasty were successful in all 3 patients. Two years after the procedure, no patient had required amputation or experienced recurrent infection.

Conclusion: A free FC-ALT flap can provide adequate coverage of infected MTKP and deserves to be viewed as a valid alternative to free muscle flaps.

Keywords: Anterolateral thigh flap; Free flap; Infection; Sarcoma; Total knee arthroplasty.

MeSH terms

  • Adult
  • Arthroplasty, Replacement, Knee
  • Bone Neoplasms / surgery*
  • Female
  • Femur
  • Humans
  • Infections / complications*
  • Infections / surgery*
  • Knee Prosthesis
  • Limb Salvage
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sarcoma / surgery*
  • Surgical Flaps*
  • Thigh
  • Treatment Outcome