الفهرس 
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Abstract
Infection after a TKA is an uncommon but disastrous and devastating complication. The diagnosis
and treatment of an infected TKA has become quite standardized over the last few years. With an
increasing number of TKA being performed, the number of patients with this complication is going to
increase over time.
Once infection is suspected clinically, timely diagnosis and treatment are crucial. A thorough
history and physical, complete set of radiographs and appropriate labs including CRP and ESR are
essential in the initial evaluation. Tests such as aspiration and nuclear imaging may be helpful in
unclear cases or when labs are concerning for infection.
The goals in the treatment of infected TKA are control of the disease and restoring knee
function.The basic treatment options for an infected TKA include: antibiotic suppression, open
débridement, single-staged or 2-staged resection and reimplantation of another prosthesis,
resection arthroplasty, arthrodesis and amputation. Although two-stage surgery is generally
believed as the most successful decision, chronic infection forces surgeons to look for other
alternatives.
Knee arthrodesis is the method of choice for salvaging the
unrevisable knee with chronic prosthetic infections especially infections with highly virulent,
antibiotic-resistant microbes, polymicrobial infections, soft-tissue coverage problems, or
deficient extensor mechanism. Successful knee fusion provides patients with a stable limb for
ambulation, Knee arthrodesis usually relieves the patient’s pain and has been associated with a low
reinfection rate. External fixation, compression plating, and intramedullary devices are
well-established options for knee fusion.
Intramedullary nail fixation may be the best method of obtaining prolonged rigid fixation if severe
bone loss exists, and may offer the best chance of fusion. There are different models of knee
nails used to achieve arthrodesis: long intramedullary rod, interlocking nail, short huckstep nail
and modular titanium nail.
Modular nails have advantages over long nails, including use of a single incision at the knee,
modularity for different canal diameters, and intraoperative compression. However, modular nails
are difficult to remove in cases of solid fusion with persistent or recurring infections.
Like other arthrodesis knee techniques, intramedullary nail fusion has complications which include,
haematoma, peroneal palsy, nail migration, delayed or non-union, nail breakage, distal tibial
fractures and reccurence of infection.\
As regard to overall function and outcomes of arthrodesis using intramedullary nail it providing
satisfactory functional outcomes beginning with immediate weight bearing, minimal leg- length
discrepancy, bone union and acceptable rate of recurrence of infection.