title: CLINICAL OUTCOME AFTER INFECTED TOTAL KNEE AND TOTAL HIP ARTHROPLASTY.
abstract: OBJECTIVE
  Infection after total hip (THA) and knee arthroplasty (TKA) is a serious complication which typically leads to a long lasting and intensive surgical and medicamentous treatment. The aim of this study was to identify factors that influence outcome after revision surgery caused by prosthetic infection.
  
  
  METHODS
  We retrospectively analyzed 64 patients who had revision surgery between 1989 and 2009 due to periprosthetic infection. We examined a total of 69 joints (TKA: 36%, THA: 64%), follow-up 5.1 years (0.5-21 years) after the initial surgical intervention. The mean patient age at time of surgery was 67 years old (43-79 years old). Clinical data and scores including the Western Ontario and McMaster Universities (WOMAC)-Index, the Harris Hip Score (HHS) and the Hospital for Special Surgery Score (HSS) were surveyed.
  
  
  RESULTS
  There was no difference in clinical scores regarding treatment between a single and a multiple stage treatment regime. Infections with multiple microorganisms and Enterococcus spp. lead to a significantly higher number of interventions. Using a modified Tsukayama system we classified 24% as type I, 34% type II and 42% type III- infections, with no differences in clinical outcome. Overweight patients had a significantly lower HHS and WOMAC-score. Immunosuppression leads to a worse WOMAC and HSS-Score. An increased number of procedures was associated to a limping gait.
  
  
  CONCLUSIONS
  Thorough surgical technique leads to good clinical results independent of infection-type and treatment philosophy. Level of Evidence III, Case Control Study.
authors.affiliation: . University Hospital Tübingen, Hoppe-Seyler-Str. 3, Tübingen, Alemanha.
authors.forename: Falk
authors.initials: F
authors.lastname: Mittag
authors.affiliation: . University Hospital Tübingen, Hoppe-Seyler-Str. 3, Tübingen, Alemanha.
authors.forename: Carmen Ina
authors.initials: CI
authors.lastname: Leichtle
authors.affiliation: . University Hospital Tübingen, Hoppe-Seyler-Str. 3, Tübingen, Alemanha.
authors.forename: Michael
authors.initials: M
authors.lastname: Schlumberger
authors.affiliation: . University Hospital Tübingen, Hoppe-Seyler-Str. 3, Tübingen, Alemanha.
authors.forename: Ulf Gunther
authors.initials: UG
authors.lastname: Leichtle
authors.affiliation: . University Hospital Tübingen, Hoppe-Seyler-Str. 3, Tübingen, Alemanha.
authors.forename: Markus
authors.initials: M
authors.lastname: Wünschel
keywords: Arthroplasty; Bacteria.; Hip; Infection; Knee