Treatment and Outcome of Periprosthetic Joint Infection in Unicompartmental Knee Arthroplasty

Chalmers, Brian P.; Kapadia, Milan; Chiu, Yu-Fen; Henry, Michael; Miller, Andy O.; Carli, Alberto

doi:10.1016/j.arth.2020.02.036

Cited by 19 publications

(55 citation statements)

References 27 publications

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“…A majority of infections present acutely. Chalmers et al reported the initial presentation at a mean of 6.4 months after primary UKA, with 67% of infections presenting within the first 4 weeks [2]. Similarly, Hernandez et al found that 11 of 15 patients (73%) had become symptomatic within 90 days of the original surgery [4].…”

Section: Discussionmentioning

confidence: 98%

“…The overall rate of treatment failure is disappointing, as the rate of reinfection is reported to be 24% to 29% at 1 year [2,4]. A deeper stratification suggests that DAIR carries the greatest risk of treatment failure between 38% by Chalmers et al and 39% by Hernandez et al [2,4]. Further, those knees that are successfully cleared of infection with this technique may be at increased risk of opposite compartment degeneration.…”

Section: Case Reports In Orthopedicsmentioning

confidence: 99%

“…The literature on managing PJI in UKA is sparse, and the established guidelines remain unclear. The overall rate of treatment failure is disappointing, as the rate of reinfection is reported to be 24% to 29% at 1 year [2,4]. A deeper stratification suggests that DAIR carries the greatest risk of treatment failure between 38% by Chalmers et al and 39% by Hernandez et al [2,4].…”

Section: Case Reports In Orthopedicsmentioning

confidence: 99%

“…Further, those knees that are successfully cleared of infection with this technique may be at increased risk of opposite compartment degeneration. Several authors have reported subsequent revision TKA for progression of arthritic change in the opposite compartment [2,4,7].…”

Section: Case Reports In Orthopedicsmentioning

confidence: 99%

“…Infection in total knee arthroplasty (TKA) is one of the leading causes of failure, and the efficacy of treatment options for PJI in total knee arthroplasty is well-outlined [1]. Fortunately, the rate of infection in unicompartmental knee arthroplasty (UKA) is comparably lower, reportedly ranging from 0.1% to 0.8% [2].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Modified Two-Stage Exchange for Periprosthetic Joint Infection in UKA

Yun

Qutami

Pasko

2020

Case Reports in Orthopedics

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Periprosthetic joint infection (PJI) is a rare complication following unicompartmental knee arthroplasty (UKA), and current management guidelines are still evolving. This report presents a novel surgical technique of resection arthroplasty with an articulated hemispacer as part of a 2-stage exchange protocol. A 66-year-old man developed a culture-negative PJI four months after a medial UKA. Rather than conventional full resection arthroplasty, the patient underwent partial resection with preservation of the lateral and patellofemoral compartments to maintain vascularized bone stock. An articulating hemispacer fashioned from the old implants after sterilization was reimplanted medially to preserve function during the course of antibiotic treatment. After successful eradication of infection, the patient underwent an uncomplicated conversion total knee replacement facilitated by prior preservation of bone stock. No stems or augments were needed. Therefore, a partial resection arthroplasty with an articulating hemispacer used in a 2-stage exchange protocol may be a reasonable option to eradicate infection and maintain function. In future cases of infected UKA, this technique warrants further consideration and investigation.

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Section: Discussionmentioning

confidence: 98%