Free antero-lateral thigh flap for total knee prosthesis coverage after infection complicating malignant tumour resection - 30/06/18

Doi : 10.1016/j.otsr.2018.05.006

Cécile Philandrianos ^a,^b,^⁎ , Jean-Camille Mattei ^a,^c, Alexandre Rochwerger ^a,^c, Baptiste Bertrand ^a,^b, Charlotte Jaloux ^a,^b, Dominique Casanova ^a,^b
^a Aix-Marseille université, 13284 Marseille, France
^b Service de chirurgie plastique et réparatrice, AP–HM, hôpital Conception, 13005 Marseille, France
^c Service de chirurgie orthopédique, AP–HM, hôpital Nord, 13915 Marseille, France

^⁎Corresponding author. Service de chirurgie plastique, hôpital de la Conception, 147, boulevard Baille, 13905 Marseille, France.Service de chirurgie plastique, hôpital de la Conception147, boulevard BailleMarseille13905France

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Abstract

Background

Infection is a common complication of major lower limb-sparing surgery with massive total knee prosthesis (MTKP) reconstruction after extensive tumour resection. When free tissue transfer is required to cover the prosthesis, musculo-cutaneous flaps are usually preferred based on proven efficacy when used in both one-stage and two-stage procedures. The use of a free fascio-cutaneous antero-lateral thigh (FC-ALT) flap in 3 patients with infected knee reconstructions is reported here.

Material and method

A retrospective study was performed of 3 patients in whom a free FC-ALT flap was used during a two-stage procedure to treat MTKP infection after femoral sarcoma resection.

Results

Free FC-ALT flap transfer and exchange arthroplasty were successful in all 3 patients. Two years after the procedure, no patient had required amputation or experienced recurrent infection.