title: Preoperative prediction of failure following two-stage revision for knee prosthetic joint infections.
abstract: While two-stage revision is the gold standard for treatment of knee prosthetic joint infection (PJI), it is not without risk. The purpose of this study was to develop a tool to preoperatively predict the probability that a two-stage revision would fail to eradicate knee PJI. 3,809 surgical cases were retrospectively reviewed and data were collected from 314 charts. Overall, 105 (33.4%) cases failed to eradicate PJI using this procedure. Univariate analysis identified multiple variables independently associated with reinfection. Logistic regression was used to generate a model (bootstrap-corrected concordance index of 0.773) predicting failure of infection eradication. Preoperative knowledge of a high probability of failure may improve risk assessment, lead to more aggressive management, and allow for time to consider alternative therapies.
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Fady Youssef
authors.initials: FY
authors.lastname: Sabry
authors.forename: Leonard
authors.initials: L
authors.lastname: Buller
authors.forename: Sarim
authors.initials: S
authors.lastname: Ahmed
authors.forename: Alison K
authors.initials: AK
authors.lastname: Klika
authors.forename: Wael K
authors.initials: WK
authors.lastname: Barsoum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis / Q000009:adverse effects* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D057234:Preoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D055815:Young Adult
keywords: infection; nomogram; predictive modeling; revision; total knee arthroplasty