Abstract
Deep soft tissue defects after complicated primary or revision total knee arthroplasty
(TKA) can be devastating to the patient and technically challenging. The purpose of
this review was to (1) discuss different methods used to provide coverage for deep
defects of the knee following TKA, as well as to (2) report on their success rates.
A comprehensive literature search was performed. Reports were only included if they
(1) were case series, (2) were level III studies or above (including retrospective
cohort studies and meta-analyses), (3) were in English, and (4) discussed the outcome
of graft or flap coverage of soft tissue defects after total knee arthroplasty. A
total of 28 case series and four retrospective comparative studies were retrieved.
In 16 studies, 195 out of 241 patients who received gastrocnemius flaps (81%) experienced
successful outcomes. In seven studies including 84 patients that underwent fasciocutaneous
flap coverage, over 90% of patients experienced successful outcomes. In the four studies
examining 144 patients with delayed versus prophylactic soft tissue reconstruction,
up to 81% of patients experienced a successful outcome. Various factors must be taken
into consideration when assessing full-thickness defects over a TKA and collaboration
between plastic and orthopaedic surgeons is required to select the optimal approach.
Keywords
flap reconstruction - deep tissue defects - outcomes - total knee arthroplasty - revision
