Vascularised knee joint transplantation in man: the first two years experience.

OBJECTIVE

To describe our early experience with a new technique for restoring destroyed knee joints to give reasonable functional results.

DESIGN

Observational clinical trial.

SETTING

Level-1-Trauma centre, Germany.

SUBJECTS: 5 patients with large bone defects of the knee and loss of the extensor apparatus caused either by serious injury alone, or infection after serious injury.

INTERVENTIONS: Transplantation of fresh and perfused knee joints with a vascular pedicle from multiorgan donors under immunosuppression.

MAIN OUTCOME AND MEASURES: Ability to walk, need to remove one transplanted joint.

RESULTS

Four patients are able to walk, the range of movement being from 50 degrees-120 degrees. The first patient additionally had to be provided with a total knee joint arthroplasty. In the third patient the graft became infected and had to be removed. She finally had an arthrodesis and bone lengthening by the Ilizarov technique.

CONCLUSIONS

Transplantation of the knee joint may be an alternative to bone lengthening or amputation for patients with total loss of the extensor apparatus.