BACKGROUND: Periprosthetic joint infection has been the leading cause of failure following TKA surgery. The gold standard for infection control has been a two-staged revision TKA. There have been few reports on mid- to long-term survivorship, functional outcomes, and fate of patients with a failed two-stage revision TKA. QUESTIONS/PURPOSES: Therefore, we determined (1) the mid-term survivorship of two-stage revision TKA, (2) the function of patients in whom infection was controlled, and (3) the outcome of patients with a failed two-stage revision due to recurrent infection. METHODS: We retrospectively reviewed 239 patients who underwent 253 two-stage revision TKAs for periprosthetic infection. There were 239 patients (253 knees), 104 men and 135 women, with a mean age of 70 ± 10 years at the time of two-stage revision and a mean BMI of 31.53 ± 6.74 kg/m2. During followup, we obtained WOMAC and The Knee Society Clinical Rating Scores and radiographs. The minimum followup was 1 year (median, 4 years; range, 1-17 years). RESULTS: Thirty-three patients experienced a failed two-staged TKA. Sixteen patients experienced failure due to recurrent sepsis. There were 17 failures for aseptic causes. CONCLUSION: The overall infection-free survivorship for two-stage revision TKA was 85% at 5 years and 78% at 10 years. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
BACKGROUND: Periprosthetic joint infection has been the leading cause of failure following TKA surgery. The gold standard for infection control has been a two-staged revision TKA. There have been few reports on mid- to long-term survivorship, functional outcomes, and fate of patients with a failed two-stage revision TKA. QUESTIONS/PURPOSES: Therefore, we determined (1) the mid-term survivorship of two-stage revision TKA, (2) the function of patients in whom infection was controlled, and (3) the outcome of patients with a failed two-stage revision due to recurrent infection. METHODS: We retrospectively reviewed 239 patients who underwent 253 two-stage revision TKAs for periprosthetic infection. There were 239 patients (253 knees), 104 men and 135 women, with a mean age of 70 ± 10 years at the time of two-stage revision and a mean BMI of 31.53 ± 6.74 kg/m2. During followup, we obtained WOMAC and The Knee Society Clinical Rating Scores and radiographs. The minimum followup was 1 year (median, 4 years; range, 1-17 years). RESULTS: Thirty-three patients experienced a failed two-staged TKA. Sixteen patients experienced failure due to recurrent sepsis. There were 17 failures for aseptic causes. CONCLUSION: The overall infection-free survivorship for two-stage revision TKA was 85% at 5 years and 78% at 10 years. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Authors: Michael Drexler; Tim Dwyer; Paul R T Kuzyk; Yona Kosashvilli; Mansour Abolghasemian; Gilad J Regev; Assaf Kadar; Tal Frenkel Rutenberg; David Backstein Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-08-14 Impact factor: 4.342
Authors: Heinrich M L Mühlhofer; C Knebel; Florian Pohlig; Susanne Feihl; Norbert Harrasser; Johannes Schauwecker; Rüdiger von Eisenhart-Rothe Journal: Int Orthop Date: 2017-12-14 Impact factor: 3.075
Authors: Kevin L Garvin; Ryan E Miller; Todd M Gilbert; Anthony M White; Elizabeth R Lyden Journal: Clin Orthop Relat Res Date: 2018-02 Impact factor: 4.176