title: Cementless modular intramedullary nail without bone-on-bone fusion as a salvage procedure in chronically infected total knee prosthesis: long-term results.
abstract: OBJECTIVE
  Our purpose was to evaluate long-term results of two-stage cementless intramedullary nailing without achieving bone-to-bone fusion for treating chronically infected total knee arthroplasty (TKA).
  
  
  METHODS
  Thirty-eight patients treated according to the same protocol were retrospectively evaluated for clinical, functional, laboratory and radiological outcomes.
  
  
  RESULTS
  Spacer exchange was necessary for infection persistence in one case. At a minimum two year follow-up, 34 patients (89.5%) showed no infection recurrence; among these 34 patients, 29 (85.3%) reported no or moderate pain [visual analogue scale (VAS) ≤3]; mild to moderate handicap (Lequesne Algofunctional Index < 7.5) was observed in 18 patients (52.9%). No patient underwent revision for aseptic loosening, and no nail breakage was observed.
  
  
  CONCLUSIONS
  Two-stage cementless intramedullary nailing without achieving bone-to-bone fusion is a viable option for treating chronically infected TKA in selected, complex cases.
authors: Centro di Chirurgia Ricostruttiva e delle Infezioni Osteo-articolari, Istituto Ortopedico I.R.C.C.S. Galeazzi, Via Riccardo Galeazzi, 4, Milano, 20161, Italy.
authors: Sara
authors: S
authors: Scarponi
authors: Lorenzo
authors: L
authors: Drago
authors: Delia
authors: D
authors: Romanò
authors: Nicola
authors: N
authors: Logoluso
authors: Andrea
authors: A
authors: Peccati
authors: Enzo
authors: E
authors: Meani
authors: Carlo L
authors: CL
authors: Romanò
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000453:epidemiology; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D007720:Knee Prosthesis / Q000382:microbiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016459:Prosthesis-Related Infections / Q000601:surgery*; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome