One-stage revision surgery provides infection eradication and satisfying outcomes for infected knee arthroplasty in selected patients

Expert Rev Anti Infect Ther. 2021 Jul;19(7):945-948. doi: 10.1080/14787210.2021.1851597. Epub 2020 Dec 3.

Abstract

Objectives: We conducted a retrospective study to evaluate the outcomes of one-stage revision total knee arthroplasty (TKA) in terms of eradication of the infection, improvement of pain, and knee function.

Methods: Between 2009 and 2016, 20 patients underwent one-stage revision TKA for the treatment of a prosthetic joint infection (PJI). Inclusion criteria were: patients nonimmunocompromised with minimal or moderate bone loss, known organisms with known sensitivity. Assessment included clinical signs of infection eradication, range of motion, Knee Society clinical rating score, visual analog scale pain score, and radiographic assessment.

Results: After a mean follow-up of 6.2 years (range, 2-10 years), none of the patients had signs suggesting recurrent infection. Follow-up examination showed significant improvement of all variables compared to preoperative values (p < 0.001).

Conclusions: One-stage revision surgery provides infection eradication and satisfying subjective functional outcomes for infected knee arthroplasty in selected patients.

Expert opinion: One-stage revision knee arthroplasty is a valuable resource to approach PJIs in selected patients whose infecting micro-organism and sensitivity are determined before surgery. In order to succeed strict inclusion criteria should be applied, as only non-immunocompromised patients with healthy soft tissues with minimal or moderate bone loss are eligible for this procedure.

Keywords: Total knee arthroplasty; infected knee arthroplasty; one-stage revision arthroplasty; prosthetic joint infection; revision surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Arthroplasty, Replacement, Knee / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / microbiology
  • Knee Joint / surgery
  • Male
  • Middle Aged
  • Pain / etiology*
  • Pain / surgery
  • Pain Measurement
  • Prosthesis-Related Infections / diagnosis
  • Prosthesis-Related Infections / surgery*
  • Range of Motion, Articular
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome