Infection recurrence factors in one- and two-stage total knee prosthesis exchanges

Abstract

III.

Single-Stage Revision Surgery in Infected Total Knee Arthroplasty: A PRISMA Systematic Review

“…Of the sixteen included studies [8,11,12,13,14,15,16,17,18,19,21,22,23,24,25,26] that met the inclusion criteria, thirteen were retrospective studies [8,11,12,13,14,15,16,17,21,22,23,24,25]; nine were retrospective cohort studies [8,11,12,15,17,22,23,24,25], one was a retrospective case series [21], one was a retrospective descriptive study [16], one was a case-control study [13], and one was a large retrospective observational database study [14]. Three were prospective studies [18,19,26]; two prospective cohort studies [19,26], and one prospective observational cohort study [18].…”

“…Several surgical techniques are available for the management of established PJI in knee arthroplasty and these commonly include a single or two–stage revision. Controversy however exists regarding the use of single–stage revision surgery as some studies in the literature report a higher reinfection rate [3,8,11,12,13,14,15,16,17,18,27]. In this study, we systematically reviewed the available evidence regarding the effectiveness of single–stage revision in infected TKA with a focus on reinfection rate and functional outcome.…”

“…Studies investigating single-stage revision show promising results. The reinfection rate (RR) of single-stage revision surgery (5–25%) [8,11,12,13,14,15,16,17,18] is comparable to two-stage revision (9–20%) [3]. In particular, in a study of 28 highly selected patients undergoing single-stage revision surgery for chronically infected knee arthroplasties, it was shown that patients were free of reinfection after a 3 year follow-up [8].…”

What’s New in Musculoskeletal Infection: Update Across Orthopaedic Subspecialties

“…The benefit of 1-stage exchange is that all arthroplasty materials are removed, decreasing the likelihood of persistent biofilm bacteria 60 . One study found that female patients who underwent 2-stage exchange arthroplasty with static spacers had an increased risk of reinfection compared with patients who underwent 1-stage exchange or 2-stage exchange with a dynamic spacer 61 . A systematic review comparing the 2 procedures demonstrated that 1-stage exchange arthroplasty had significantly lower reinfection rates in studies published after 2000, with higher functional outcomes 62 .…”

Periprostetik eklem enfeksiyonlarında tek aşamalı revizyon

“…Tekrarlama riskini arttırmadan daha fazla konfor sunmak için, tek aşamalı değişim tercih edilebilir. [69] Dönen menteşeli implantların kullanıldığı, revizyonun sonuçlarının değerlendirildiği 10 yıllık bir seride, tek aşamalı değişim ile posterior kapsül ve kollateral bağların agresif debridmanı sonrası %93 oranında enfeksiyon kontrolü sağlanmıştır. [70] On iki çalışmanın derlendiği, 1200'den fazla eklemin tek aşamalı değişiminin en az beş yıllık takiplerinde, enfeksiyona rastlanmama oranı %83'tür.…”