Arthrodesis of the Knee by Double-Plating

A technique for arthrodesis of the knee, using two eight-inch stainlesssteel plates applied to the anterior and medial aspects of the femur and tibia at 90 degrees to each other, is presented. The procedure has been used successfully on four knees with neurogenic arthropathy secondary to tabes dorsalis, three knees with old septic arthritis, two knees with tuberculous arthritis, three knees with post-traumatic arthritis, as well as four knees with rheumatoid arthritis, one knee with a segmental resection of the proximal end of the tibia for giant-cell tumor, and one knee with degenerative arthritis. There was only one failure, and this knee went on to solid fusion after a second plating procedure. External support was seldom required, and walking with crutches shortly after operation was possible in most instances, with partial weight-bearing usually permitted by three months and full weight-bearing after six months. The method described makes it possible to preserve maximum length and even to bridge defects; it assures arthrodesis in the optimum position with minimum hospitalization. Of the eighteen cases reported, removal of the plates was subsequently performed in five instances.