scholarly journals Infected total knee arthroplasty treatment outcome analysis

2012 ◽  
Vol 69 (6) ◽  
pp. 504-509 ◽  
Author(s):  
Dragan Radoicic ◽  
Zoran Popovic ◽  
Radoslav Barjaktarovic ◽  
Jugoslav Marinkovic
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Micrococcus Luteus ◽  
Outcome Analysis ◽  
Two Stage ◽  
Military Medical Academy ◽  
Infected Total Knee Arthroplasty ◽  
Primary Tkas ◽  
Total Knee ◽  
The Military

Background/Aim. Infected total knee arthroplasty (TKA) is a topic of great importance, because its diagnosing and treatment requires a lot of resources, and often has an unsatisfactory outcome. The aim of this study was to analyze the outcome of the treatment of infection developed following TKA. Methods. This retrospective study of infected TKAs was performed in the period from 1998 to 2008 in the Orthopedics & Traumatology Clinic of the Military Medical Academy (MMA) in Belgrade. A total of 654 primary and revised TKAs were performed in the said period. We registered and surgically treated 28 infected TKAs (primary TKAs: MMA - 22, other institutions - 6). The incidence of TKA infection in the MMA was 3.36%. The most common pathogens were: Staphylococcus aureus - 14 (50%) cases, and Staph. epidermidis - 3 (10.7%) cases. Other isolated pathogens were: Enterococcus faecalis, Klebsiella pneum., Klebsiella spp., Streptoccocus viridans, Seratia spp, Micrococcus luteus and Peptostreptococcus spp. In one case we had mixed anaerobic flora, and in 3 cases cultures were negative. We analyzed diagnostic challenges, risk factors (such as age and previous viscosupplementation) and treatment outcomes in our series of infected TKAs. Results. In our series 2 infections healed after iv antibiotics and debridement, 1 patient responded to open debridement with component retention, 4 patients responded fully to one-stage reimplantation, 10 cases responded fully to two-stage reimplantation, 11 patients ended with arthrodesis and we had 1 patient with above knee amputation. Conclusion. Two-stage reimplantation remains gold standard for treatment of infected TKA, and we recommend it as treatment of choice for eradication of infection. The antibiotic loaded spacer prothesis concept in most cases allows infection eradication, good function and high patient satisfaction.

Antibiotic-Loaded Spacer for Two-Stage Revision of Infected Total Knee Arthroplasty

2016 ◽  
Vol 30 (03) ◽  
pp. 231-237 ◽  
Author(s):  
Eugenio Vecchini ◽  
Francesco Perusi ◽  
Marco Scaglia ◽  
Tommaso Maluta ◽  
Franco Lavini ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Two Stage ◽  
Infected Total Knee Arthroplasty ◽  
Total Knee

scholarly journals Revision of Infected Total Knee Arthroplasty: Two-Stage Reimplantation Using an Antibiotic-Impregnated Static Spacer

2013 ◽  
Vol 5 (3) ◽  
pp. 180 ◽  
Author(s):  
Antonio Silvestre ◽  
Fernando Almeida ◽  
Pablo Renovell ◽  
Elena Morante ◽  
Raúl López
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Two Stage ◽  
Infected Total Knee Arthroplasty ◽  
Total Knee

An intraoperatively moulded PMMA prostheses like spacer for two-stage revision of infected total knee arthroplasty

The Knee ◽  
2011 ◽  
Vol 18 (6) ◽  
pp. 464-469 ◽  
Author(s):  
Sandro Kohl ◽  
Dimitrios S. Evangelopoulos ◽  
Hendrik Kohlhof ◽  
Andreas Krueger ◽  
Maximilian Hartel ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Two Stage ◽  
Infected Total Knee Arthroplasty ◽  
Total Knee

scholarly journals Efficiency and Blood Loss of Various Spacer and Intramedullary Dowel Constructs in Two-Stage Treatment of Total Knee Arthroplasty

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Hanna House, BS ◽  
Mary Ziemba-Davis, BA ◽  
Michael Meneghini, MD
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Knee Arthroplasty ◽  
Operative Time ◽  
Operating Time ◽  
Treatment Protocol ◽  
Two Stage ◽  
Tourniquet Time ◽  
Infected Total Knee Arthroplasty ◽  
Total Knee

Background and Hypothesis: Treatment for infected total knee arthroplasty (TKA) employs antibiotic-eluding articulating or static spacers, with or without intramedullary (IM) dowels between implant resection and reimplantation. While it is unknown which spacer type is more efficient intra-operatively, IM dowels require additional time for fabrication. Surgical efficiency is critical to minimizing anesthesia time and blood loss, especially in complex surgeries with compromised hosts. We quantified operative time and postoperative intra-articular blood loss based on spacer type and the use of IM dowels. Project Methods: 103 consecutive infected TKAs treated from 2010-2019 were retrospectively reviewed. Outcome variables included operative time and intraarticular drain rate. Covariates included sex; age, BMI; ASA-PS classification; surgeon; McPherson infection classification; tourniquet time; tranexamic acid (TXA) use; intrathecal anesthesia, length of stay, and blood transfusion. Multivariate analyses were used. Results: The sample was 52% female with average age of 66±9 years and average BMI of 36±9 kg/m2. Articulating spacers without dowels (ASwoD), articulating spacers with dowels (ASwD), and static spacers with dowels were used in 57.3%, 21.4%, and 21.4% of knees, respectively. Longer mean operating time was observed when static spacers with dowels were used at resection (162 vs.130 ASwoD/140 ASwD minutes; p=0.001) and reimplantation (187 vs. 149 ASwoD/148 ASwD minutes; p=0.017). At reimplantation, drain rate was highest when articulating spacers with dowels were used (37 vs. 20/26 mL/hr), but not when TXA was used (p=0.002). Conclusion and Potential Impact: Articulating and static spacers provide equivalent infection eradication, and the necessity of IM dowels has not been thoroughly studied. In light of this equivalency, it is important to understand other costs associated with spacer types and IM dowels. Our observations that spacer/dowel constructs affect time under anesthesia and blood loss may contribute to the efficiency and safety of the two-stage treatment protocol.

scholarly journals Reinfection Rate and Its Associated Factors after Two-Stage Revision for Infected Total Knee Arthroplasty

2021 ◽  
Author(s):  
Chang Hyun Nam ◽  
Su Chan Lee ◽  
Kyungwon Choi ◽  
Ji-Hoon Baek ◽  
Hye Sun Ahn
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Multivariable Logistic Regression Analysis ◽  
Two Stage ◽  
Reinfection Rate ◽  
Infected Total Knee Arthroplasty ◽  
History Of ◽  
Total Knee ◽  
History Of Cancer

Abstract Background: Two-stage revision is the gold standard for treatment of infected total knee arthroplasty. The purpose of our study was to evaluate the reinfection rate of two-stage revision and to analyze the factors affecting the prognosis of two-stage revision for infected total knee arthroplasty.Methods: One hundred seven cases of two-stage revision for infected total knee arthroplasty were reviewed retrospectively from March 2006 to November 2019. We evaluated possible risk factors between success and reinfection groups. Statistical analyses included multivariable logistic regression analysis to examine the relative contribution of risk factors to the success of two-stage revision. Results: There were 19 cases of reinfection (17.8%) after two-stage revision in our center. Between the success and reinfection groups, there was a significant difference in history of cancer (p=0.015). Also, multivariable logistic regression analysis of risk factors demonstrated history of cancer (HR 5.928, p=0.015). There were no statistically significant differences in reinfection relative to other risk factors. Conclusions: In subjects undergoing two-stage revision for infected total knee arthroplasty, history of cancer was a risk factor for reinfection, though no other significant differences between risk factors was shown for reinfection.Trial registration: Retrospectively registeredLevel of evidence: IV

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