Long Term Treatment Results for Deep Infections of Total Knee Arthroplasty

• Published in: The Journal of arthroplasty 2015-09, Vol.30 (9), p.1623-1628
• Main Authors: Wang, Kevin H., MD, Yu, Stephen W., MD, Iorio, Richard, MD, Marcantonio, Andrew J., DO, MBA, Kain, Michael S., MD
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - methods; Bacterial Infections - drug therapy; Bacterial Infections - surgery; Debridement - methods; Diabetes Complications - diagnosis; Humans; irrigation and debridement; Knee Prosthesis; long term outcomes; Orthopedics; peri-prosthetic joint infection; Prospective Studies; Prosthesis-Related Infections - drug therapy; Prosthesis-Related Infections - surgery; Reoperation; Replantation - methods; revision knee arthroplasty; timing; Treatment Outcome; two stage revision
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2015.04.008

Abstract This study aims to identify the long-term outcomes of total knee arthroplasty (TKA) treated for deep infection. 3270 consecutive primary and 175 revision TKAs were followed prospectively. There were 39 deep infections (1.16%): 29 primary (0.9%) and 10 revision (5.7%) cases. Two-stage resection and re-implantation procedure was performed in 13 primary cases with 10/13 (77%) successfully resolved. Early (< 1 month) Irrigation and Debridement (I&D) was performed in 16 primary cases with 100% success. Late (> 4 months) I&D was performed in 6 cases with 5/6 (83.3%) successful. Infection following revision TKA resulted in poor outcomes with both two-stage (2/4 successful) and I&D (2/6 successful). Deep infection after primary TKA can be successfully resolved with I&D and appropriate antibiotic treatment in the early postoperative course.