title: Single-stage revision for fungal peri-prosthetic joint infection: a single-centre experience.
abstract: Fungal peri-prosthetic infections of the knee and hip are rare but likely to result in devastating complications. In this study we evaluated the results of their management using a single-stage exchange technique. Between 2001 and 2011, 14 patients (ten hips, four knees) were treated for a peri-prosthetic fungal infection. One patient was excluded because revision surgery was not possible owing to a large acetabular defect. One patient developed a further infection two months post-operatively and was excluded from the analysis. Two patients died of unrelated causes. After a mean of seven years (3 to 11) a total of ten patients were available for follow-up. One patient, undergoing revision replacement of the hip, had a post-operative dislocation. Another patient, undergoing revision replacement of the knee, developed a wound infection and required revision 29 months post-operatively following a peri-prosthetic femoral fracture. The mean Harris hip score increased to 74 points (63 to 84; p < 0.02) in those undergoing revision replacement of the hip, and the mean Hospital for Special Surgery knee score increased to 75 points (70 to 80; p < 0.01) in those undergoing revision replacement of the knee. A single-stage revision following fungal peri-prosthetic infection is feasible, with an acceptable rate of a satisfactory outcome.
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Germany.
authors.forename: T O
authors.initials: TO
authors.lastname: Klatte
authors.forename: D
authors.initials: D
authors.lastname: Kendoff
authors.forename: A F
authors.initials: AF
authors.lastname: Kamath
authors.forename: V
authors.initials: V
authors.lastname: Jonen
authors.forename: J M
authors.initials: JM
authors.lastname: Rueger
authors.forename: L
authors.initials: L
authors.lastname: Frommelt
authors.forename: M
authors.initials: M
authors.lastname: Gebauer
authors.forename: T
authors.initials: T
authors.lastname: Gehrke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D001424:Bacterial Infections / Q000209:etiology / Q000601:surgery; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies
keywords: fungal peri-prosthetic infection; one-stage exchange; single-stage revision