Comparison of Outcomes Following Knee Resection Arthrodesis using an Intramedullary Nail versus Dual Plating for Tumours About the Knee.

INTRODUCTION

For extensive osseous involvement of primary tumours in the distal femur and proximal tibia, knee resection arthrodesis (KRA) is an economic alternative to endoprosthetic reconstruction in developing countries. Enneking (1977) described the use of an intramedullary (IM) nail for KRA and is still regarded as the most reliable method for fusion. We sought to determine if dual plating or IM nailing for KRA would produce comparable outcomes.

MATERIAL AND

METHODS

This is a cross-sectional study of 30 patients who underwent KRA with either IM nail or dual plates for tumours about the knee. Demographic and surgical profile, functional scores using the Musculoskeletal Tumour Society (MSTS) score, and incidence of complications were determined.

RESULTS

Mean follow-up was 2.28 years (SD 20.4). IM nail was utilised in 12 (40%) and dual plating in 18 (60%). 21 complications occurred, with 11 (52.38%) and 10 (47.62%) occurring in the IM nail and dual plating group respectively. MSTS score was higher with the IM nail (23.5 vs 22.5). Mean operative time was longer with the IM nail compared to dual plating (8.29 vs 7.80 hours). Blood loss was higher with the IM nail (1309.09 vs 1138.89mL).

CONCLUSION

Outcomes of IM nailing and dual plating KRA are comparable, including the incidence of complications. While blood loss and operative time were noted to be longer in the IM nailing group, and hospital admission was longer in the dual plating group, the difference was not significant. Larger, prospective studies are recommended to report outcomes for fusion done following tumour resection.