title: Two-stage revision for infected total knee arthroplasty: our experience with interval prosthesis.
abstract: BACKGROUND
  To review our practice of performing two-stage revision for infected total knee arthroplasty using articulating interval prosthesis and to compare the incidence of the recurrence of infection and re-operation rate in patients undergoing two-stage revision as planned with the group of patients who choose not to proceed to the second stage.
  
  
  METHODS
  This study is a retrospective review of 60 consecutive patients undergoing a two-stage revision for infected total knee arthroplasty using articulating interval prosthesis. All cases managed by a single surgeon using a uniform peri-operative protocol, and short-course parenteral antibiotic therapy.
  
  
  RESULTS
  Thirty-four patients (57%) (Group 1) underwent the two-stage revision as planned. However, twenty-six patients (43%) (Group 2) opted not to have a second-stage procedure as the first-stage and interval prosthesis had eradicated the infection, resolved the pain and achieved good functional outcome. There were five cases of recurrent infection in the 60 patients (8%) at a mean follow-up 5 years. In those completing the two-stage revision, two patients had recurrent infection. Of the patients who retained the interval prosthesis, there were three recurrent infections. There was no statistically significant difference between the groups in terms of recurrence of infection or re-revision.
  
  
  CONCLUSIONS
  Two-stage revision with interval prostheses represents a safe and reliable method of treating infected knee prosthesis; however, there may be a role for one-stage revision in selected cases.
authors.affiliation: Cardiff and Vale NHS Trust, Cardiff, UK, nporth@yahoo.com.
authors.forename: N
authors.initials: N
authors.lastname: Prasad
authors.forename: V
authors.initials: V
authors.lastname: Paringe
authors.forename: R
authors.initials: R
authors.lastname: Kotwal
authors.forename: A
authors.initials: A
authors.lastname: Ghandour
authors.forename: R
authors.initials: R
authors.lastname: Morgan Jones
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods*; D001843:Bone Cements; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D020127:Recovery of Function; D012008:Recurrence; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D005839:Gentamicins