title: Polymorphonuclear cell count on frozen section is not an absolute index of reimplantation in infected total knee arthroplasty.
abstract: We evaluated the outcomes in 15 patients with infected total knee arthroplasty (TKA) who underwent reimplantation following excision arthroplasty in the presence of five to twenty polymorphonuclear cells per high power field (hpf) on intraoperative frozen section. At a minimum of two years of follow-up, we achieved 100% infection eradication rate with normalization of C-reactive protein levels, no radiolucency on plain radiographs and no clinical evidence of recurred infection. Successful reimplantation for infected TKA is possible despite of the presence of five to twenty polymorphonuclear cells per hpf in intraoperative frozen section with clear appearance of the tissues in the operative field. Clinical and serological confirmations of infection eradication before reimplantation as well as healthy operative findings are equally important factors for a successful reimplantation.
authors: Department of Orthopedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea.
authors: Woo-Shin
authors: WS
authors: Cho
authors: Seoung-Eun
authors: SE
authors: Byun
authors: Won-Joon
authors: WJ
authors: Cho
authors: Young-Sun
authors: YS
authors: Yoon
authors: Kunal
authors: K
authors: Dhurve
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D002097:C-Reactive Protein / Q000032:analysis; D020878:Device Removal; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D011237:Predictive Value of Tests; D016459:Prosthesis-Related Infections / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012092:Replantation
chemical_list: D002097:C-Reactive Protein
keywords: infection; intraoperative frozen sections; polymorphonuclear cell count; revision; total knee arthroplasty