Clinical outcome after treatment of infected primary total knee arthroplasty

Acta Orthop Belg. 2002 Dec;68(5):500-7.

Abstract

Twenty-six consecutive cases of infected primary total knee arthroplasties were treated at our institution from 1989 through 2000. Eleven patients had debridement and irrigation performed within 2 months of index arthroplasty or hematogenous spread; only one infection was eradicated. Twenty-five patients had their prostheses removed; 17 had two-stage revision arthroplasty, following which infection was eradicated in 15; one had a permanent spacer, 7 had arthrodesis (following failed revision arthroplasty in one) and 2 had a femur amputation (following failed revision arthroplasty in one) at follow-up of mean 24 months. Infections were cured equally well with revision arthroplasty and arthrodesis. Among the 15 patients who ended up with revision arthroplasty, 11 had a better range of motion compared to the index arthroplasty, but 8 had daily pain. We present our treatment protocol, which eradicated 15/17 (88%) infections in patients treated with two-stage revision arthroplasty.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amputation, Surgical
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Debridement
  • Female
  • Femur / surgery
  • Humans
  • Male
  • Middle Aged
  • Range of Motion, Articular
  • Reoperation
  • Retrospective Studies
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / therapy*
  • Therapeutic Irrigation
  • Treatment Outcome