BACKGROUND Tenuous blood supply carries a risk of wound-healing problems and subsequent infection following total knee arthroplasty (TKA). This risk may be increased by the presence of previous incisions. Performing a sham incision procedure allows for detection of wound-healing problems prior to performing TKA. The purpose of this retrospective case series is to describe the indications for and technique of a sham incision procedure in patients with previous knee incisions who underwent TKA following this procedure and to report the clinical outcomes observed in these patients following further surgery. METHODS Patients who had prior knee incisions, had undergone a sham incision prior to TKA, and had a minimum follow-up of 2 years were identified, and their cases were retrospectively reviewed. The identified cases typically adhered to the surgeon's standard protocol, which consisted of making a midline incision adventitious to TKA, dissecting down to deep fascia, and closing the wound with suture. Incisions were then observed for at least 4 weeks to determine the viability of the skin flaps before TKA was performed via the same incision. RESULTS A total of 47 knees in 47 patients were included in the study cohort. TKA was performed at an average of 21.1 weeks (range, 4 to 163 weeks) following the sham incision. There were no cases of skin necrosis or periprosthetic joint infection at an average follow-up of 4.6 years (range, 2 to 12 years) after sham incision. A total of 11 patients (23.4%) required manipulation under anesthesia for stiffness. CONCLUSIONS In our series, no patients developed skin necrosis or periprosthetic joint infection following TKA subsequent to a sham incision procedure, suggesting that healed sham incisions are safe to use for TKA and may be considered prior to TKA in cases in which local previous incisions increase the risk of wound-healing problems. LEVEL OF EVIDENCE Prognostic Level IV . See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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既往膝关节切口患者假切口手术后全膝关节置换术的结果。


背景 血液供应稀薄会带来全膝关节置换术 （TKA） 后伤口愈合问题和随后感染的风险。这种风险可能会因先前切口的存在而增加。执行假切口手术可以在执行 TKA 之前检测伤口愈合问题。本回顾性病例系列的目的是描述既往膝关节切口患者在手术后接受 TKA 的假切口手术的适应症和技术，并报告在这些患者进一步手术后观察到的临床结果。方法 确定了既往有膝关节切口、在 TKA 前接受过假切口且至少随访 2 年的患者，并回顾性评价他们的病例。确定的病例通常遵守外科医生的标准方案，其中包括在 TKA 不定的情况下做一个中线切口，解剖至深筋膜，并用缝合线缝合伤口。然后观察切口至少 4 周以确定皮瓣的活力，然后再通过同一切口进行 TKA。结果 研究队列共纳入 47 例患者的 47 个膝关节。假切口后平均 21.1 周 （范围，4 至 163 周） 进行 TKA。假切口后平均随访 4.6 年 （范围，2 至 12 年） 时，没有皮肤坏死或假体周围关节感染的病例。共有 11 例患者 （23.4%） 需要在麻醉下进行僵硬操作。 结论 在我们的系列中，没有患者在假切口手术后 TKA 后出现皮肤坏死或假体周围关节感染，这表明愈合的假切口可以安全地用于 TKA，并且在局部先前切口增加伤口愈合问题风险的情况下，可以在 TKA 之前考虑。证据级别 预后 IV 级 .有关证据级别的完整描述，请参阅作者说明。