Are Patients With a History of Septic Arthritis Undergoing Total Knee Arthroplasty at Higher Risk for Revision Surgery? A Single-Center Study.
antibiotic-loaded bone cement
periprosthetic joint infection
postinfectious osteoarthritis
septic arthritis
total knee arthroplasty
Journal
The Journal of arthroplasty
ISSN: 1532-8406
Titre abrégé: J Arthroplasty
Pays: United States
ID NLM: 8703515
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
21
12
2019
revised:
13
02
2020
accepted:
28
02
2020
pubmed:
6
4
2020
medline:
18
3
2021
entrez:
6
4
2020
Statut:
ppublish
Résumé
The decision to perform a total knee arthroplasty (TKA) on a previously infected knee is made complicated by the higher risk for both a periprosthetic joint infection (PJI) and early failure. There is currently no standard in the treatment strategy for this group of patients. We here report the outcomes of performing a primary TKA on patients with a prior septic knee arthritis. The aim of our study is to analyze the survival rates of patients with a history of septic arthritis undergoing TKA. From 2010 to 2018, all patients treated in our institution with a minimum follow-up of 1 year, who have previous histories of knee joint infections and underwent a primary TKA were included in the study. All patients underwent the same surgical protocol and were given systemic and local antibiotic treatment. Of the 68 knees, there were 4 surgical revisions (5.9%). These included 2 septic revisions due to PJI (2.9%), 1 open arthrolysis for arthrofibrosis (1.5%), and 1 aseptic revision for implant loosening (1.5%). Sixty-four (64) knees (94%) had survived without any surgical interventions and the Kaplan-Meier analysis demonstrated an overall survivorship free from PJI of 97.1% at a mean of 5 years (range 1-9, standard deviation ±2.5 years). TKA is a suitable option for patients with a prior septic arthritis of the knee, provided that proper surgical technique and the utilization of systemic and local antibiotics are employed. Level III, therapeutic study.
Sections du résumé
BACKGROUND
The decision to perform a total knee arthroplasty (TKA) on a previously infected knee is made complicated by the higher risk for both a periprosthetic joint infection (PJI) and early failure. There is currently no standard in the treatment strategy for this group of patients. We here report the outcomes of performing a primary TKA on patients with a prior septic knee arthritis. The aim of our study is to analyze the survival rates of patients with a history of septic arthritis undergoing TKA.
METHODS
From 2010 to 2018, all patients treated in our institution with a minimum follow-up of 1 year, who have previous histories of knee joint infections and underwent a primary TKA were included in the study. All patients underwent the same surgical protocol and were given systemic and local antibiotic treatment.
RESULTS
Of the 68 knees, there were 4 surgical revisions (5.9%). These included 2 septic revisions due to PJI (2.9%), 1 open arthrolysis for arthrofibrosis (1.5%), and 1 aseptic revision for implant loosening (1.5%). Sixty-four (64) knees (94%) had survived without any surgical interventions and the Kaplan-Meier analysis demonstrated an overall survivorship free from PJI of 97.1% at a mean of 5 years (range 1-9, standard deviation ±2.5 years).
CONCLUSION
TKA is a suitable option for patients with a prior septic arthritis of the knee, provided that proper surgical technique and the utilization of systemic and local antibiotics are employed.
LEVEL OF EVIDENCE
Level III, therapeutic study.
Identifiants
pubmed: 32247677
pii: S0883-5403(20)30226-6
doi: 10.1016/j.arth.2020.02.065
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1857-1861Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.