Utilization of the gastrocnemius flap for post-traumatic knee reconstruction: a systematic review

Rohun Gupta; Joseph Weisberger; Isabel Herzog; Jacquelyn Roth; Edward S Lee

doi:10.1007/s00590-024-03938-2

Utilization of the gastrocnemius flap for post-traumatic knee reconstruction: a systematic review

Eur J Orthop Surg Traumatol. 2024 Apr 18. doi: 10.1007/s00590-024-03938-2. Online ahead of print.

Authors

Rohun Gupta¹, Joseph Weisberger², Isabel Herzog³, Jacquelyn Roth⁴, Edward S Lee²

Affiliations

¹ Oakland University William Beaumont School of Medicine Auburn Hills, Rochester, MI, USA.
² Department of Plastic Surgery, University Hospital, Newark, NJ, USA.
³ Rutgers New Jersey Medical School, Newark, NJ, USA.
⁴ Rutgers New Jersey Medical School, Newark, NJ, USA. jr1658@njms.rutgers.edu.

PMID: 38634884
DOI: 10.1007/s00590-024-03938-2

Abstract

Purpose: High-energy injuries to the knee may lead to extensive soft tissue loss, fractures, and potential loss of extensor function. The gastrocnemius flap is a prominent reconstructive option for patients with injuries involving the knee and proximal third of the lower extremity. To the best of our knowledge, there has not been an informative review that has evaluated outcomes of patients who have undergone post-traumatic knee reconstruction with a pedicled medial or lateral gastrocnemius flap. The goal of this study is to assess outcomes in patients who have undergone gastrocnemius flap reconstruction after traumatic injuries to the knee.

Methods: The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology. Four databases were utilized including PubMed, Cochrane Reviews, Embase, and CINAHL. Our search criteria consisted of the following keywords: gastrocnemius, flap, knee, and traum*.

Results: A total of 204 studies were imported for screening, from which five papers met our final inclusion/exclusion criteria. The most common studies utilized in this review were case series followed by retrospective chart reviews. In total, 43 patients with traumatic soft tissue knee defects were included with an average patient age of 27.28 years. All patients had successful and clinical viable flaps post-operatively, and there were a total of five patients who had complications.

Conclusion: The gastrocnemius flap has demonstrated to be an effective option for individuals undergoing post-traumatic knee reconstruction. Infection rates, loss of mobility, and scarring represent a minority of complications that may be seen when this reconstructive technique is utilized. Still, additional randomized controlled trials and retrospective studies are required in order to further evaluate for other potential complications that may occur in this patient population.

Keywords: Gastrocnemius flap; Post-traumatic knee pain; Post-traumatic knee reconstruction; Soft tissue defects; Traumatic knee injuries.

Publication types

Review