Outcome of a second two-stage reimplantation for periprosthetic knee infection.
Recurrent or persistent infection after two-stage exchange arthroplasty for previously infected total knee replacement is a challenging clinical situation. We asked whether a second two-stage procedure could eradicate the infection and preserve knee function. We evaluated 18 selected patients with failed two-stage total knee arthroplasty implantation treated with a second two-stage reimplantation between 1999 and 2005. Failure of treatment was defined as recurrence or persistence of infection. The minimum followup was 24 months (mean, 40 months; range, 24-83 months). Recurrent or persistent infection was diagnosed in four of 18 patients, two of whom were successfully treated with a third two-stage exchange arthroplasty. Knee Society score questionnaires administered at the last followup showed an average Knee Society knee score of 73 points (range, 24-100 points) and an average functional score of 49 points (range, 20-90 points). The data suggest repeat two-stage exchange arthroplasty is a reasonable option for eradicating periprosthetic infection, relieving pain, and achieving a satisfactory level of function for some patients.


METHODS
Level IV, therapeutic study.
Azzam
Khalid
K
Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Rothman Institute, 925 Chestnut St., 5th Floor, Philadelphia, PA 19107, USA.
McHale
Kevin
K
Austin
Matthew
M
Purtill
James J
JJ
Parvizi
Javad
J
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D011859:Radiography; D012008:Recurrence; D012086:Reoperation / Q000379:methods*; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents