Clinical outcome after treatment of infected primary total knee arthroplasty.
Twenty-six consecutive cases of infected primary total knee arthroplasties were treated at our institution from 1989 through 2000. Eleven patients had debridement and irrigation performed within 2 months of index arthroplasty or hematogenous spread; only one infection was eradicated. Twenty-five patients had their prostheses removed; 17 had two-stage revision arthroplasty, following which infection was eradicated in 15; one had a permanent spacer, 7 had arthrodesis (following failed revision arthroplasty in one) and 2 had a femur amputation (following failed revision arthroplasty in one) at follow-up of mean 24 months. Infections were cured equally well with revision arthroplasty and arthrodesis. Among the 15 patients who ended up with revision arthroplasty, 11 had a better range of motion compared to the index arthroplasty, but 8 had daily pain. We present our treatment protocol, which eradicated 15/17 (88%) infections in patients treated with two-stage revision arthroplasty.
Husted
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Department of Orthopedic Surgery, Hvidovre University Hospital, 2650 Hvidovre, Denmark. henrikhusted@dadlnet.dk
Toftgaard Jensen
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D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003646:Debridement; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology / Q000628:therapy*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome