Results after Late Polymicrobial, Gram-negative, and Methicillin-resistant Infections in Knee Arthroplasty

Cordero‐Ampuero, José; Esteban, Jaime; García-Rey, Eduardo

doi:10.1007/s11999-009-1224-9

Cited by 24 publications

(21 citation statements)

References 22 publications

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“…10,15 However, the infection control rate improved to 100% after repeated debridement and repeated 2-stage revision. Cordero-Ampuero et al 14 reported that 34 (81%) of 42 late chronic infections treated with debridement or 2-stage exchange arthroplasty maintained functioning total knee prostheses at the last evaluation, similar to the findings of the current study (76%). In addition, the current study investigated the number of operations needed for eradication of infection.…”

Section: Results Of Acute Early Infection Based On Resistant Organismsupporting

confidence: 89%

“…12,13 However, they did not compare infections with and without resistant organisms or classify infections as early vs late. Cordero-Ampuero et al 14 reported 47 late TKA infections and found no difference in the eradication of MRSA/ MRSE and non-MRSA/MRSE infections. However, these authors did not investigate differences in eradication at initial treatment, functional prosthetic knees, and the number of operations between MRSA/ MRSE and non-MRSA/MRSE infections.…”

mentioning

confidence: 97%

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Treatment of 50 Deep Infections After Total Knee Arthroplasty

Matsumoto¹,

Ishida²,

Tsumura³

et al. 2015

Orthopedics

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The prevalence of infections caused by methicillin-resistant organisms has increased, causing difficulty in the treatment of prosthetic joint infection. A multicenter study was performed to review 50 patients with deep infections with or without a resistant organism, such as methicillin-resistant Staphylococcus aureus, at the site of total knee arthroplasty. A group of 13 patients with early deep infections and 4 patients with acute hematogenous infections underwent treatment with debridement, antibiotic therapy, and retention of the prosthesis with revision of the polyethylene insert. Thirty-three patients with late chronic infections were treated with challenging prosthesis retention for prostheses that had not loosened or 2-stage exchange arthroplasty for prostheses that had loosened. Mean duration of follow-up was 4.7±1.8 years. No significant differences in resultant functional knees and mean number of operations were observed between 7 patients with resistant early deep infections and 6 patients with nonresistant early deep infections. However, 24 patients with nonresistant chronic infections showed significant improvement in resultant functional knees (24 of 24; 100%) and fewer mean operations (2.8 times) compared with 9 patients with resistant chronic infections (1 of 9, 11%, and 4.3 times, respectively). The remaining 8 patients with resistant chronic infections (89%) had arthrodesis (3 patients) or underwent above-the-knee amputation (1 patient) or spacer arthroplasty (4 patients). Although patients with resistant early postoperative deep infections showed good results that were similar to those in patients with nonresistant early infections, those with resistant late chronic infections had a significantly inferior success rate compared with those who had nonresistant late chronic infections.

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Section: Results Of Acute Early Infection Based On Resistant Organismsupporting

confidence: 89%

mentioning

confidence: 97%

Treatment of 50 Deep Infections After Total Knee Arthroplasty

Matsumoto¹,

Ishida²,

Tsumura³

et al. 2015

Orthopedics

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“…Additionally, two-stage reimplantation is reported to be even more successful when used in low-grade TKA infections [2, 4, 9, 39, 46–48]. Volin et al [48] reported a 94.6 % success rate in methicillin-sensitive S. aureus infections.…”

Section: Resultsmentioning

confidence: 99%

Low-grade periprosthetic knee infection: diagnosis and management

Vasso

Panni

2014

J Orthopaed Traumatol

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Diagnosis and management of low-grade periprosthetic knee infection are still controversial and debatable. The diagnosis of low-grade infection after total knee arthroplasty is often complex, as clinical symptomatology and diagnostic studies are highly conflicting and knees often exhibit well-fixed components. Although the criterion standard for staged reimplantation is interim placement of an antibiotic-loaded spacer, less-invasive surgical procedures have been advocated for managing infections caused by low-virulence bacteria. Debridement with polyethylene exchange and single-stage reimplantation could offer advantages, such as fewer surgeries, reduced potential for intraoperative complications, and lower direct social costs. The aim of this narrative review was to analyze the literature to evaluate the effectiveness of different surgical procedures in managing low-grade periprosthetic knee infections. Additionally, the most reliable investigations for diagnosing total knee infection caused by low-virulence bacteria were reviewed.Level of evidence Level V.

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“…Other retrospective studies with eight to 21 patients had higher rates of infection control between 87% and 93% [6,23,40,52] (Table 1). Patients with infections caused by methicillinresistant Staphylococcus aureus (MRSA) or methicillinresistant Staphylococcus epidermidis (MRSE) were not included in these studies; infections with these pathogens generally have lower rates of infection control than periprosthetic infections with other pathogens [10,31,38,39]. None of these studies report function (as reflected by knee scores) or analyses of potential factors that influence the rate of infection control after one-stage revisions.…”

Section: Introductionmentioning

confidence: 99%