Resection arthroplasty: an alternative to arthrodesis for salvage of the infected total knee arthroplasty.
Arthrodesis remains the procedure of choice for salvage of an infected total knee arthroplasty in patients with relatively minor preprosthetic arthroplasty disability. Patients with very severe preprosthetic disability resulting from multiarticular disease or other systemic disease may be treated best by a resection arthroplasty. Systemic sepsis can be eliminated in almost all patients, and drainage can be eliminated in most. Those patients who find the stability of a resection arthroplasty inadequate for their needs can have a secondary arthrodesis performed with an intramedullary rod, which yields a high probability of success. External immobilization is not necessary. The advantages of a two-stage arthrodesis are that it is an elective procedure, performed in a limb free of sepsis. The patient has been psychologically prepared for the arthrodesis, and the two-stage procedure has a high probability of success. Neither the underlying diagnosis, nor the infecting organism, nor the type of infected prosthesis is a reliable predictor of success or failure of either a resection arthroplasty or a second-stage arthrodesis.
D000368:Aged; D001424:Bacterial Infections / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D007720:Knee Prosthesis; D008124:Locomotion; D008875:Middle Aged; D009068:Movement; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation