Abstract
Treatment of skin necrosis after arthroplasty often poses a challenge, especially when it is accompanied by exposed prostheses. The standard treatment for this complex wound is to remove the prosthesis and perform a second arthroplasty after the infection is controlled. Patients in whom a second arthroplasty is difficult could lose joint function. We treated skin defects and retained the once- or non-exposed prostheses to maintain joint function when we judged that the infection was limited to the wound and could potentially be controlled.
We present our algorithm for the treatment of ulceration after arthroplasty and the clinical outcomes of 4 patients with 5 ulcerations. Good outcomes were obtained for 4 joints with exposed prostheses after successful flap coverage during the clinical course (range, 18-61 months) ; however, we failed to treat one wound reaching the fascia in depth after total knee arthroplasty, and removed the prosthesis because of deep infection. Hence, from on our clinical experience, we believe that a flap cover could be useful for exposed prostheses after the infection is controlled.
