DOI: 10.1093/bjs/znad258.312 ISSN:

1142 Using Lipofilling to Improve Skin Quality Following Severe Radiation Necrosis to Enable Successful Joint Replacement – a Case Report and Literature Review

M ri Satkunabalan, D Cavallaro, K Govindan Srinivasan, J Jagadeesan
  • Surgery



A 74-year-old female patient presented with severe osteoarthritis and pathological fracture of the left knee, following treatment with radiotherapy of osteosarcoma over a decade ago. Surgical management of the fracture was initially not possible, due to radiation-induced fibrosis of the skin. She was referred to the plastic surgery department where she underwent a total of three sessions of fat grafting over nine months. The rigotomy approach was applied to the large area of irradiated skin. As a result, her skin quality improved such that a successful total knee replacement was possible. The outcome of this was better mobility and improved quality of life.


Skin quality after radiotherapy can limit surgical options, even decades after treatment. Fat grafting, also known as lipofilling, is a commonly utilised reconstructive and cosmetic adjunct. However, recent reports of its effect on skin quality are gaining popularity. We present a case of successful use of fat transfer to improve irradiated skin quality prior to successful joint replacement; this is a novel use case which we believe to be the first published.

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