Abstract
BackgroundModular knee arthrodesis (MKA) is a salvage treatment option for patients with challenging periprosthetic joint infections (PJI). The purpose of this study was to investigate the outcomes of patients who underwent MKA for PJI with a single technique and determine if specific factors are associated with MKA failure.MethodsThis was a retrospective review of 81 patients who underwent MKA at a single institution. Knee Society Scores were recorded before MKA and at the final follow-up (mean 52 months). Poisson regression was used to calculate rate ratios for MKA failure secondary to infection.ResultsThe mean patient age was 67 years; most patients were McPherson B hosts (56.8%) and had type 3 extremities (53.1%), and all had a type III infection (chronic, >4 wks). Forty-six percent of patients had a prior explantation (59.5% failed 2-stage, 40.5% failed spacer). Staphylococcus epidermidis and Staphylococcus aureus were the most common organisms, 22.2% and 18.5%, respectively. Thirty percent of patients had at least one reoperation, excluding reimplantation (14.8% irrigation and debridement/wound closure, 9.9% MKA exchange, and 7.4% amputation). Of 82.7% of MKA patients with no evidence of infection, 82.1% (56 patients) underwent reimplantation endoprosthetic reconstruction, and 67.3% of these remained infection-free at the final follow-up.DiscussionMKA is a salvage option for challenging PJI cases that may serve as definitive surgical management or as a bridge to endoprosthetic reconstruction for patients who have failed prior infection control procedures.
Highlights
Periprosthetic joint infection (PJI) remains a devastating complication of total knee arthroplasty (TKA)
Patients were included if they underwent Modular knee arthrodesis (MKA) for periprosthetic joint infections (PJI) and were excluded if MKA was performed for oncological purposes
Eighty-one patients were included in the study, 51.9% were female, and the mean patient age at the time of MKA was 67 years
Summary
Periprosthetic joint infection (PJI) remains a devastating complication of total knee arthroplasty (TKA). PJI is the most common reason for revision TKA, accounting for 25.2% of revision cases [3] It is associated with a significant decrease in patient quality of life and increase in. Modular knee arthrodesis (MKA) is a salvage treatment option for patients with challenging periprosthetic joint infections (PJI). Discussion: MKA is a salvage option for challenging PJI cases that may serve as definitive surgical management or as a bridge to endoprosthetic reconstruction for patients who have failed prior infection control procedures.
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