Results of different surgical procedures on total knee arthroplasty infections

Wasielewski, Ray C.; Barden, Regina M.; Rosenberg, Aaron G.

doi:10.1016/s0883-5403(96)80134-3

Cited by 85 publications

(44 citation statements)

References 39 publications

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“…Despite being the most common treatment for infected TKA, two-stage exchange arthroplasty has a relatively high failure rate ranging from 9% to 20% [8,9,11,13,15,19,20]. When infection with resistant organisms is also included, the failure rate rises, between 24% and 33% [11,14,16].…”

Section: Discussionmentioning

confidence: 99%

“…Mont et al reported six reinfections in 69 cases treated with two-stage exchange arthroplasty including one patient treated with a second two-stage revision versus four patients with arthrodesis of the knee [15]. Wasielewski et al reported five patients with reinfection among 50 knees treated with twostage exchange arthroplasty; one of those patients underwent second two-stage exchange arthroplasty and subsequently became reinfected [19]. The outcome of a second two-stage exchange arthroplasty was dismal in one of the two patients treated for reinfection in another study, with one patient having an above-the-knee amputation [4].…”

Section: Discussionmentioning

confidence: 99%

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Outcome of a Second Two-stage Reimplantation for Periprosthetic Knee Infection

Azzam

McHale

Austin

et al. 2009

Clinical Orthopaedics &Amp; Related Research

102

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Recurrent or persistent infection after two-stage exchange arthroplasty for previously infected total knee replacement is a challenging clinical situation. We asked whether a second two-stage procedure could eradicate the infection and preserve knee function. We evaluated 18 selected patients with failed two-stage total knee arthroplasty implantation treated with a second two-stage reimplantation between 1999 and 2005. Failure of treatment was defined as recurrence or persistence of infection. The minimum followup was 24 months (mean, 40 months; range, 24-83 months). Recurrent or persistent infection was diagnosed in four of 18 patients, two of whom were successfully treated with a third two-stage exchange arthroplasty. Knee Society score questionnaires administered at the last followup showed an average Knee Society knee score of 73 points (range, 24-100 points) and an average functional score of 49 points (range, 20-90 points). The data suggest repeat two-stage exchange arthroplasty is a reasonable option for eradicating periprosthetic infection, relieving pain, and achieving a satisfactory level of function for some patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outcome of a Second Two-stage Reimplantation for Periprosthetic Knee Infection

Azzam

McHale

Austin

et al. 2009

Clinical Orthopaedics &Amp; Related Research

102

View full text Add to dashboard Cite

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“…Excellent success rates have been reported for revision for infection [1,2]; however, recurrent periprosthetic sepsis is a devastating problem, which frequently requires resection arthroplasty, arthrodesis, or amputation [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Intramedullary Arthrodesis of the Knee in the Treatment of Sepsis After TKR

et al. 2007

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“…It is indicated in acute infections of less than 2 weeks' duration, always associated with specific antibiotic therapy for six to eight weeks (16) .…”

Section: Treatmentmentioning

confidence: 99%

“…All prosthesis components are then replaced and orthopedic cement impregnated with antibiotic is used between prosthesis interfaces and bones. Table 4 -Therapy options of infections following KJA agudas com menos de duas semanas de evolução, sempre associado à antibioticoterapia sistêmica específica durante seis a oito semanas (16) .…”

Section: Prosthesis Replacementmentioning

confidence: 99%

Infecção pós-artoplastia total do joelho: considerações e protocolo de tratamento

et al. 2004

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RESUMOAs artroplastias totais de joelho apresentaram nas últimas décadas apreciável melhora em relação aos resultados cirúrgi-cos devido à difusão de técnicas operatórias precisas e ao desenvolvimento de materiais de implante de alta tecnologia. Apesar disso ainda estão sujeitas a complicações, sendo a infecção a mais difícil de ser solucionada.Neste artigo discutimos os fatores de risco para infecção, classificação, condições clínicas e cirúrgicas, assim como mé-todos diagnósticos. As opções de tratamento incluem supressão com antibióticos, manutenção da prótese, troca imediata ou em dois tempos dos componentes protéticos e os procedimentos de salvação. Além disto, os autores apresentam o protocolo de tratamento utilizado no Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da FMUSP pelo Grupo de Artroplastias.Descritores: Artroplastia do Joelho; Infecção, Fatores de risco. INTRODUÇÃOO conceito de substituição da superfície articular do joelho, para o tratamento de doenças graves dessa articulação, tem recebido atenção desde o século XIX. Já em 1860, Verneuil (15) sugeriu a interposição de partes moles para a reconstrução articular do joelho. Mas foi no início do século passado que a artroplastia total de joelho (ATJ) apresentou grande evolução, devido ao desenvolvimento de materiais de implante adequados para a interposição articular -como ligas metálicas e acrí-lico -, e ao aprimoramento da técnica cirúrgica, alavancado principalmente por Campbell(1) , MacIntosh (10) e McKeever (11) .Atualmente, existem à disposição próteses de joelho com desenhos e materiais de alta tecnologia, que, aliado ao aumento da expectativa de vida da população mundial e ao diagnós-tico mais preciso das doenças ortopédicas, fez aumentar sensivelmente a indicação e a sobrevida das mesmas. Infection following total knee joint arthroplasty: considerartions and treatment ANA LÚCIA LEI MUNHOZ LIMA SUMMARYTotal knee arthroplasty results have markedly improved during the last decades due to diffusion of accurate surgical techniques and development of high-technology implant materials. However, complications still develop, infection being that of most difficult resolution.Risk factors for infection, classification of infections, clinical and surgical conditions, as well as diagnostic methods are discussed in the present article. Therapeutic options include suppression by antibiotic therapy, maintenance of the prosthesis, immediate or twostep replacement of prosthetic, and salvage procedures. In addition, the authors describe the treatment protocol used by the Arthroplasty Group in the Institute of Orthopedics and Traumatology (I.O.T.) of the Clinics Hospital of the Medical School of the São Paulo University.

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Results of different surgical procedures on total knee arthroplasty infections

Cited by 85 publications

References 39 publications

Outcome of a Second Two-stage Reimplantation for Periprosthetic Knee Infection

Outcome of a Second Two-stage Reimplantation for Periprosthetic Knee Infection

Intramedullary Arthrodesis of the Knee in the Treatment of Sepsis After TKR

Infecção pós-artoplastia total do joelho: considerações e protocolo de tratamento

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