Fasciocutaneous Advancement Flap for Anterior Open Wounds After Primary and Revision Total Knee Arthroplasty

Large wounds after total knee arthroplasty (TKA) may not be amenable to primary closure and may require soft tissue coverage. A bipedicle fasciocutaneous advancement flap for anterior wounds after TKA that can be achieved without need for a trained microsurgeon is proposed. Retrospective chart review was performed. Sixteen adult patients who had non-closable primary wounds after both primary and revision TKA and received the bipedicle fasciocutaneous advancement flap were included. On average, patients were older than 65 years and had multiple comorbidities. All patients had healed wounds by final follow up, including four who received the flap after revision TKA. The surgical technique for the flap is included. In conclusion, the bipedicle fasciocutaneous advancement flap is a viable coverage option for wounds not amenable to primary closure after TKA, both primary and revision. No microsurgery training or tools are necessary to perform this procedure. (Journal of Surgical Orthopaedic Advances 34(2):086-089, 2025)

Key words: total knee arthroplasty, revision total knee arthroplasty, wound complications, fasciocutaneous flap, microsurgery