title: Results of 2-stage reimplantation for infected total knee arthroplasty.
abstract: Optimum treatment of the infected total knee arthroplasty has not been clearly established. To clarify the efficacy of two-stage reimplantation, experience with 66 infected total knee arthroplasties in 64 patients who had been treated with 2-stage reimplantation total knee arthroplasty between September 1980 and October 1993 was reviewed. Of these, 55 knees in 54 patients were available for follow-up examinations at an average of 61.9 months (range, 28-146 months). The initial diagnoses were rheumatoid arthritis (14 knees) and osteoarthritis (41 knees). Reimplantation was successful in 80.0% of knees with low-virulence organisms (coagulase-negative Staphylococcus, Streptococcus), 71.4% with polymicrobial organisms, and 66.7% with high-virulence organisms (methicillin-resistant Staphylococcus aureus). Reimplantation was successful in 82% of patients with osteoarthritis and in 54% of patients with rheumatoid arthritis (P = .024). The success rate was 92% if infection occurred after primary arthroplasty but only 41% if after multiple previous knee operations (arthroscopy, osteotomy, or revision total knee arthroplasty) (P < .001).
authors.affiliation: Cleveland Center for Joint Reconstruction, Ohio 44115, USA.
authors.forename: K
authors.initials: K
authors.lastname: Hirakawa
authors.forename: B N
authors.initials: BN
authors.lastname: Stulberg
authors.forename: A H
authors.initials: AH
authors.lastname: Wilde
authors.forename: T W
authors.initials: TW
authors.lastname: Bauer
authors.forename: M
authors.initials: M
authors.lastname: Secic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D013211:Staphylococcus aureus / Q000302:isolation & purification / Q000472:pathogenicity; D013212:Staphylococcus epidermidis / Q000302:isolation & purification / Q000472:pathogenicity; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D013291:Streptococcus / Q000302:isolation & purification / Q000472:pathogenicity; D014774:Virulence
chemical_list: D000900:Anti-Bacterial Agents