A comparison of healing and complication rates between common flaps utilized in total knee arthroplasty: a review of the literature
Abstract Background Flap reconstruction with perforator, fasciocutaneous, muscular, and/or free microvascular flaps is utilized to cover wound defects and improve vascularization and antibiotic/nutrient delivery. Flap use in revision procedures for total knee arthroplasty has been explored previousl...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | Knee Surgery & Related Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43019-022-00145-3 |
| _version_ | 1819025949771956224 |
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| author | Akhil A. Chandra Filippo Romanelli Alex Tang Luke Menken Maximilian Zhang Adam Feintisch Frank A. Liporace Richard S. Yoon |
| author_facet | Akhil A. Chandra Filippo Romanelli Alex Tang Luke Menken Maximilian Zhang Adam Feintisch Frank A. Liporace Richard S. Yoon |
| author_sort | Akhil A. Chandra |
| collection | DOAJ |
| description | Abstract Background Flap reconstruction with perforator, fasciocutaneous, muscular, and/or free microvascular flaps is utilized to cover wound defects and improve vascularization and antibiotic/nutrient delivery. Flap use in revision procedures for total knee arthroplasty has been explored previously; however, current data are limited and studies comparing healing and complication rates between different flap types are lacking. Methods A literature review was performed using PubMed on 13 January 2022. Studies were included if they reported healing and complication rates for either gastrocnemius, rectus abdominis, latissimus dorsi, fasciocutaneous, chimeric, or gracilis flaps in the setting of revision total knee arthroplasty (TKA). Results The final cohort included gastrocnemius (n = 421, healing rate 73.8%, complication rate 59.9%), gracilis (n = 9, healing rate 93%, complication rate 55.6%), latissimus dorsi (n = 41, healing rate 67%, complication rate 46.3%), rectus abdominis (n = 3, healing rate 100%, complication rate 0%), fasciocutaneous (n = 78, healing rate 70%, complication rate 19.2%), and chimeric flaps (n = 4, healing rate 100%, complication rate 25%). There was no significant difference when comparing healing rates across flap types (p = 0.39). There was a significant difference when comparing complication rates across flap types (p < 0.0001), with a significant difference being noted between gastrocnemius and fasciocutaneous complication rates (p < 0.0001). All other comparisons between flap types by complication rate were not significantly different. Conclusions Gastrocnemius flaps are the workhorse flap in the setting of revision TKA, as evidenced by this review. Healing rates did not vary significantly across flap types, which suggests that determining the appropriate flap for coverage of soft-tissue defects in revision TKA should be driven by defect size and location as well as physician experience and patient tolerance. |
| first_indexed | 2024-12-21T05:18:49Z |
| format | Article |
| id | doaj.art-0271f85100184e0eb9c022b2f5f8d87d |
| institution | Directory Open Access Journal |
| issn | 2234-2451 |
| language | English |
| last_indexed | 2024-12-21T05:18:49Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Knee Surgery & Related Research |
| spelling | doaj.art-0271f85100184e0eb9c022b2f5f8d87d2022-12-21T19:14:51ZengBMCKnee Surgery & Related Research2234-24512022-03-0134111410.1186/s43019-022-00145-3A comparison of healing and complication rates between common flaps utilized in total knee arthroplasty: a review of the literatureAkhil A. Chandra0Filippo Romanelli1Alex Tang2Luke Menken3Maximilian Zhang4Adam Feintisch5Frank A. Liporace6Richard S. Yoon7Rutgers Robert Wood Johnson Medical SchoolDivision of Orthopaedic Trauma and Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center – RWJ Barnabas HealthDivision of Orthopaedic Trauma and Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center – RWJ Barnabas HealthDivision of Orthopaedic Trauma and Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center – RWJ Barnabas HealthDivision of Orthopaedic Trauma and Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center – RWJ Barnabas HealthDivision of Orthopaedic Trauma and Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center – RWJ Barnabas HealthDivision of Orthopaedic Trauma and Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center – RWJ Barnabas HealthDivision of Orthopaedic Trauma and Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center – RWJ Barnabas HealthAbstract Background Flap reconstruction with perforator, fasciocutaneous, muscular, and/or free microvascular flaps is utilized to cover wound defects and improve vascularization and antibiotic/nutrient delivery. Flap use in revision procedures for total knee arthroplasty has been explored previously; however, current data are limited and studies comparing healing and complication rates between different flap types are lacking. Methods A literature review was performed using PubMed on 13 January 2022. Studies were included if they reported healing and complication rates for either gastrocnemius, rectus abdominis, latissimus dorsi, fasciocutaneous, chimeric, or gracilis flaps in the setting of revision total knee arthroplasty (TKA). Results The final cohort included gastrocnemius (n = 421, healing rate 73.8%, complication rate 59.9%), gracilis (n = 9, healing rate 93%, complication rate 55.6%), latissimus dorsi (n = 41, healing rate 67%, complication rate 46.3%), rectus abdominis (n = 3, healing rate 100%, complication rate 0%), fasciocutaneous (n = 78, healing rate 70%, complication rate 19.2%), and chimeric flaps (n = 4, healing rate 100%, complication rate 25%). There was no significant difference when comparing healing rates across flap types (p = 0.39). There was a significant difference when comparing complication rates across flap types (p < 0.0001), with a significant difference being noted between gastrocnemius and fasciocutaneous complication rates (p < 0.0001). All other comparisons between flap types by complication rate were not significantly different. Conclusions Gastrocnemius flaps are the workhorse flap in the setting of revision TKA, as evidenced by this review. Healing rates did not vary significantly across flap types, which suggests that determining the appropriate flap for coverage of soft-tissue defects in revision TKA should be driven by defect size and location as well as physician experience and patient tolerance.https://doi.org/10.1186/s43019-022-00145-3KneeArthroplastyRevisionFlap |
| spellingShingle | Akhil A. Chandra Filippo Romanelli Alex Tang Luke Menken Maximilian Zhang Adam Feintisch Frank A. Liporace Richard S. Yoon A comparison of healing and complication rates between common flaps utilized in total knee arthroplasty: a review of the literature Knee Surgery & Related Research Knee Arthroplasty Revision Flap |
| title | A comparison of healing and complication rates between common flaps utilized in total knee arthroplasty: a review of the literature |
| title_full | A comparison of healing and complication rates between common flaps utilized in total knee arthroplasty: a review of the literature |
| title_fullStr | A comparison of healing and complication rates between common flaps utilized in total knee arthroplasty: a review of the literature |
| title_full_unstemmed | A comparison of healing and complication rates between common flaps utilized in total knee arthroplasty: a review of the literature |
| title_short | A comparison of healing and complication rates between common flaps utilized in total knee arthroplasty: a review of the literature |
| title_sort | comparison of healing and complication rates between common flaps utilized in total knee arthroplasty a review of the literature |
| topic | Knee Arthroplasty Revision Flap |
| url | https://doi.org/10.1186/s43019-022-00145-3 |
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