Tag Archives: knee

Complex Limb Reconstruction Case Report: Combined Use of the Ilizarov Technique and Taylor Spatial Frame

Complex Limb Reconstruction Case PresentationSuccessful combined use of the Ilizarov technique and Taylor spatial frame spared a healthy mother of two from the amputation of her left leg (above the knee) following a traumatic accident; the team was able to save her knee and work to heal it before any amputation needed to occur. According to J. Spence Reid, M.D., trauma surgeon, Penn State Hershey Bone and Joint Institute, “An initial attempt to reconstruct the knee failed when massive infection developed. Debridement of infected tissue and bone resulted in large bone defects.” Reid and the patient discussed amputation versus preserving the limb. “As an active young woman, the patient and her family felt very strongly about trying to preserve the leg.” Thankfully there were options.Ilizarov technique and Taylor spatial frame

After enduring six months of the Ilizarov and Taylor spatial frame techniques, and eight surgeries in 12 months, including fusion of the knee and placement of an intermedullary nail, the bone defects have fully healed and the patient is able to walk and perform most normal daily activities with no pain or ambulatory aids. Reid adds, “This was a highly personal decision to undergo an arduous, painful, and expensive series of treatments. While this approach is not for everyone, the patient and her family are very satisfied with the outcome.” Continue reading

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Graft Choices for Optimizing Anterior Cruciate Ligament Reconstruction

Patellar tendon autograft ACL reconstruction

Patellar tendon autograft ACL reconstruction [Click photo to enlarge for detail]

For young adult patients engaged in highly demanding competitive athletics or recreational sports, such as soccer, basketball, field hockey, and skiing, the cumulative risk of anterior cruciate ligament (ACL) injury, over time, is high. Young women are at particular risk, with two to eight times the incidence of ACL injury compared to men. Approximately 75,000 ACL reconstruction surgeries are performed annually in the United States. “The decision to do ACL reconstruction is partly based on the patient’s age, activity level, and post-reconstruction expectations. Some older patients may choose not to reconstruct the ACL at all if their activity levels are not demanding. These patients may instead opt to address the injury non-surgically,” explains Wayne J. Sebastianelli, M.D.  Patients who require ACL reconstruction and who want to return to pre-injury levels of aggressive activity need to receive a ligament graft; primary repair of the existing ligament is unlikely to yield a good result.   Continue reading

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