title: Modern treatment of infected total knee arthroplasty with a 2-stage reimplantation protocol.
abstract: The purpose of this study was to determine if 2-stage reimplantation for the treatment of infected total knee arthroplasty (TKA) is still effective for treating contemporary pathogens, many of which are multidrug resistant (MDR). The medical records of all cases of infected TKAs from April 1998 to March 2006 were retrospectively reviewed for data on infecting organism and success of treatment. Of 72 patients (75 knees), with a minimum of 2 years of follow-up, who completed the protocol, the infection was eradicated in 90.7% (68/75 knees). Thirty-one (91.2%) of 34 of MDR infections and 42 (91.3%) of 46 of non-MDR infections were successfully treated. These results support previous studies that demonstrated the effectiveness of a 2-stage reimplantation protocol with a standard 1:8 minimal bactericidal titer for treating infections after TKA, including MDR organisms.
authors.affiliation: Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York 10021, USA.
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Westrich
authors.forename: Sarah
authors.initials: S
authors.lastname: Walcott-Sapp
authors.forename: Lindsey J
authors.initials: LJ
authors.lastname: Bornstein
authors.forename: Mathias P
authors.initials: MP
authors.lastname: Bostrom
authors.forename: Russell E
authors.initials: RE
authors.lastname: Windsor
authors.forename: Barry D
authors.initials: BD
authors.lastname: Brause
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D002985:Clinical Protocols; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007709:Klebsiella / Q000302:isolation & purification; D007719:Knee Joint / Q000382:microbiology / Q000601:surgery; D007720:Knee Prosthesis / Q000382:microbiology*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D013291:Streptococcus / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents