Clinical effects of staged joint replacement in patients with septic arthritic knee

Journal of Orthopaedic Surgery and Research

Tao Deng¹  Chi Xu¹  Guoqiang Zhang¹  Xiang Li¹  Erlong Niu¹  Wei Chai¹  Jiying Chen¹  Ming Ni¹  Jun Fu¹ 

[1] The First Medical Centre, Chinese PLA General Hospital, 100853, Beijing, People’s Republic of China;

关键词: Knee;    Septic arthritis;    Spacer;    Two-staged joint replacement;   

DOI  :  10.1186/s13018-020-02062-1

来源: Springer

【 摘 要 】

ObjectiveTo assess the clinical effect of staged joint replacement for the treatment of septic arthritic knee and the therapeutic differences between antibiotic cement beads and the tibial plateau spacer.MethodsTwenty-three patients (24 knee joints) treated with a staged joint replacement for septic arthritis knee were retrospectively reviewed between March 2014 and April 2018. At the first stage, thorough debridement and irrigation with self-made antibiotic cement beads or tibial plateau spacer were performed. After that, systemic antibiotic treatment was followed; when the infection was surely eliminated, the second-stage TKA was performed. Knee mobility (range of motion, abbreviated to ROM) and function (HSS scores system) were evaluated before surgery, in the interval period, and after joint replacement.ResultsAll patients finished follow-up, and the mean follow-up time was 27.3 months (12–54 months). Each group has one patient replaced with a homotypic spacer, and all patients eventually cleared the infection. None of the patients had a recurrent infection. The mobility and HSS scores of the two groups were significantly improved postoperation (p < 0.05). And there was no significant difference in the post-surgery ROM (p = 0.153) and the HSS score (p = 0.054) between the two groups.ConclusionStaged joint replacement is an efficacious way for septic arthritic knees, whether tibial plateau spacer or antibiotic cement beads were used, which can effectively control infection and improve knee function.

【 授权许可】

CC BY