Abstract
ABSTRACTObjectives: To identify and compare the rate of success of therapeutic modalities applied in surgeries for the treatment of infections associated with total knee arthroplasty (TKA), and to evaluate the functional outcome and pain in different therapeutic modalities by means of quality of life scores. Methods: We evaluated all patients who developed periprosthetic infection after TKA for primary or secondary osteoarthritis, in the period from January 1st, 2008 to December 31st, 2010. Results: In the study period, 29 patients with TKA had infection, and 12 of these underwent debridement and retention of the prosthesis (D+R), seven received two-stage and six one-stage exchange arthroplasties, and four patients were treated with suppressive antibiotic therapy because they could not undergo another surgical procedure. Conclusion: The D+R, one-stage revision and two-stage revision success rates were 75%, 83.3%, and 100%, respectively. The best results of quality of life (QoL) and function occur in patients undergoing D+R. In contrast, the worst QoL and functional results were obtained in patients treated with two-stage revision arthroplasty. Level of Evidence II, Prognostic Studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.
Highlights
Periprosthetic infection is a major cause of failure of total knee arthroplasty1 and its management is one of the most complex medical treatments
Debridement with prosthesis retention is the option for patients with early or late infections with signs and symptoms lasting less than three weeks, with stable prosthesis, good skin and subcutaneous tissue conditions, who used anti-biofilm-forming pathogens antibiotics
The cure of infection was defined as the absence of signs and symptoms of infection, C-reactive protein (CRP) < 2 mg/L or erythrocyte sedimentation rate (ESR) < 20 mm/h, and no radiographic signs of infection for two years after initiation of antibiotic therapy
Summary
Periprosthetic infection is a major cause of failure of total knee arthroplasty and its management is one of the most complex medical treatments. And intermediate infections are usually acquired during prosthetic implantation, whereas late infections results from hematogenous spread of the focus at a distance.8,9 Based on this classification, the therapeutic modalities proposed are: surgical debridement keeping the prosthesis and prolonged antibiotic therapy, change in one-stage or two-stages revision with short interval (2-6 weeks), two-stages revision with long intervals (6-8 weeks) and arthrodesis. In the two-stages exchange, the implementation of a new prosthesis is delayed for periods varying from four to six weeks (short interval) or more (long interval), and an antibiotic-loaded spacer can be inserted, allowing the maintenance of the limb alignment, soft tissue tension and partial mobility The problem in this case is that the spacer acts as a foreign body, and subject to displacement.. The objective of the present study is to identify therapeutic modalities applied in surgeries for the treatment of infections
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
