title: Two-stage total knee arthroplasty for non-salvageable septic arthritis in diabetes mellitus patients.
abstract: Pyogenic knee arthritis in a patient with advanced osteoarthritis is a serious medical problem. We have performed arthroscopic debridement in 136 patients with pyogenic knee arthritis from January 1999 to December 2001. Five of these patients were diabetic, they did not respond to the standard treatment protocol and they continued to have infection. For these patients, we performed open arthrotomy, with implantation of antibiotic cement as a spacer, and staged total knee arthroplasty. The clinical results were evaluated using the Hospital for Special Surgery (HSS) scoring system. At an average follow-up of 38 months (range: 29 to 46), the average pain score was 83 and the functional score was 73 with no patient having recurrence of the infection. This study shows that just as a 2-stage revision is now done for infected total knee arthroplasty, primary uncontrolled infected knees may be treated by a 2-stage arthroplasty as well.
authors.affiliation: Daejeon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Papni Arjandas
authors.initials: PA
authors.lastname: Kirpalani
authors.forename: Yong
authors.initials: Y
authors.lastname: In
authors.forename: Nam Yong
authors.initials: NY
authors.lastname: Choi
authors.forename: Hae Seok
authors.initials: HS
authors.lastname: Koh
authors.forename: Jung Man
authors.initials: JM
authors.lastname: Kim
authors.forename: Chang Whan
authors.initials: CW
authors.lastname: Han
mesh_terms: D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D003920:Diabetes Mellitus / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D007719:Knee Joint; D007720:Knee Prosthesis; D010147:Pain Measurement; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents