title: The outcome of infected total knee arthroplasty: culture-positive versus culture-negative.
abstract: OBJECTIVE
  We studied the outcome in culture-positive and culture-negative infected total knee arthroplasty (TKA).
  
  
  METHODS
  We retrospectively reviewed 140 patients with culture-positive and 102 patients with culture-negative infected TKAs. We determined the infection control rate and clinical outcome after repeated debridement, and repeated 2-stage TKA in the culture-positive and culture-negative groups. The mean follow-up was 9.3 years (range 5-14 years) in the culture-positive group and 10.6 years (5-22) in the culture-negative group.
  
  
  RESULTS
  The overall infection control rate was 56 % in both groups after the first treatment. The overall infection control rate was 90 % in the culture-positive group and 95 % in the culture-negative group. A functional knee was obtained in 90 % in the culture-positive group and 95 % in the culture-negative group.
  
  
  CONCLUSIONS
  The data suggest that treatment according to the types of infection in both culture-positive and culture-negative groups after TKA controlled infection and maintained functional TKA with a firm level of fixation for most patients. Repeated debridement and repeated two-stage exchange TKA further improved infection control rates after the initial treatment and increased the likelihood of maintaining a functional TKA.
authors.affiliation: The Joint Replacement Center, Ewha Womans, University School of Medicine, MokDong Hospital, 911-1, MokDong, YangChun-Ku, Seoul, 158-710, Republic of Korea. younghookim@ewha.ac.kr.
authors.forename: Young-Hoo
authors.initials: YH
authors.lastname: Kim
authors.affiliation: The Joint Replacement Center, Ewha Womans, University School of Medicine, MokDong Hospital, 911-1, MokDong, YangChun-Ku, Seoul, 158-710, Republic of Korea.
authors.forename: Jang-Won
authors.initials: JW
authors.lastname: Park
authors.affiliation: The Joint Replacement Center, Ewha Womans, University School of Medicine, MokDong Hospital, 911-1, MokDong, YangChun-Ku, Seoul, 158-710, Republic of Korea.
authors.forename: Jun-Shik
authors.initials: JS
authors.lastname: Kim
authors.affiliation: The Joint Replacement Center, Ewha Womans, University School of Medicine, MokDong Hospital, 911-1, MokDong, YangChun-Ku, Seoul, 158-710, Republic of Korea.
authors.forename: Dong-Jin
authors.initials: DJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001419:Bacteria / Q000302:isolation & purification*; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000628:therapy*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Culture-negative; Culture-positive; Infection control rate; TKA