Hakan Kocaoğlu1,2, Fabian Hennes3,4, Hussein Abdelaziz3, Michael E Neufeld3,5, Thorsten Gehrke3, Mustafa Citak3. 1. Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Germany. kocaoglu@ankara.edu.tr. 2. Department of Orthopaedics and Traumatology, Faculty of Medicine, Ankara University, Ibn-i Sina Hospital Talatpasa Blvd, 06100, Ankara, Turkey. kocaoglu@ankara.edu.tr. 3. Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Germany. 4. Zentrum für Rehabilitationmedizin/Sportmedizin, BG Klinikum Hamburg, Bergerdorfer Strasse 10, 21033, Hamburg, Germany. 5. Division of Lower Limb Reconstruction, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.
Abstract
PURPOSE: The rates of unicompartmental knee arthroplasty (UKA) are increasing yet little data exists regarding management of periprosthetic joint infections (PJI) after UKA, particularly utilizing one-stage revision. The aim of this study was to determine the septic and all-cause revision-free survival of UKA PJIs treated with one-stage revision, as well as functional outcomes and risk factors for failure. METHODS: A retrospective review of one-stage septic revisions with a hinged or rotating hinged implant between 2000 and 2015 at a single institution was performed. Results of 15 patients with a minimum of 3-year follow-up (mean = 93 months; range 37-217) were evaluated by means of infection control, survivorship, patient reported functional score and possible causal factors for a re-revision. Kaplan-Meier curves and Cox regression analysis were used. RESULTS: After a mean of 8 years of follow-up infection control rate was 93.3%, the survivorship free of any reoperation, including both septic and aseptic causes, was 80% at 5 years and 64.2% at ten years and average Lysholm score was 72.7 ± 21.3 (33-100). CONCLUSION: One-stage revision for PJI of UKA using a hinged knee design has excellent infection-free survival at mid to long-term follow-up. Likewise, patient reported functional outcomes are promising. However, one-third of patients required aseptic reoperation and aseptic loosening was the dominant etiology.
PURPOSE: The rates of unicompartmental knee arthroplasty (UKA) are increasing yet little data exists regarding management of periprosthetic joint infections (PJI) after UKA, particularly utilizing one-stage revision. The aim of this study was to determine the septic and all-cause revision-free survival of UKA PJIs treated with one-stage revision, as well as functional outcomes and risk factors for failure. METHODS: A retrospective review of one-stage septic revisions with a hinged or rotating hinged implant between 2000 and 2015 at a single institution was performed. Results of 15 patients with a minimum of 3-year follow-up (mean = 93 months; range 37-217) were evaluated by means of infection control, survivorship, patient reported functional score and possible causal factors for a re-revision. Kaplan-Meier curves and Cox regression analysis were used. RESULTS: After a mean of 8 years of follow-up infection control rate was 93.3%, the survivorship free of any reoperation, including both septic and aseptic causes, was 80% at 5 years and 64.2% at ten years and average Lysholm score was 72.7 ± 21.3 (33-100). CONCLUSION: One-stage revision for PJI of UKA using a hinged knee design has excellent infection-free survival at mid to long-term follow-up. Likewise, patient reported functional outcomes are promising. However, one-third of patients required aseptic reoperation and aseptic loosening was the dominant etiology.
Authors: Mustafa Citak; Kathrin Dersch; Atul F Kamath; Carl Haasper; Thorsten Gehrke; Daniel Kendoff Journal: Int Orthop Date: 2014-01-09 Impact factor: 3.075
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