Vascularised Knee Joint Transplantation in Man: the First Two Years Experience.

Objective: To describe our early experience with a new technique for restoring destroyed knee joints to give reasonable functional results. Design: Observational clinical trial. Setting: Level-1-Trauma centre, Germany. Subjects: 5 patients with large bone defects of the knee and loss of the extensor apparatus caused either by serious injury alone, or infection after serious injury. Interventions: Transplantation of fresh and perfused knee joints with a vascular pedicle from multiorgan donors under immunosuppression. Main outcome and measures: Ability to walk, need to remove one transplanted joint. Results: Four patients are able to walk, the range of movement being from 50°-120°. The first patient additionally had to be provided with a total knee joint arthroplasty. In the third patient the graft became infected and had to be removed. She finally had an arthrodesis and bone lengthening by the Ilizarov technique. Conclusions: Transplantation of the knee joint may be an alternative to bone lengthening or amputation for patients with total loss of the extensor apparatus. [ABSTRACT FROM AUTHOR]