Detailed Revision Risk Analysis after Single- vs. Two-Stage Revision Total Knee Arthroplasty in Periprosthetic Joint Infection: A Retrospective Tertiary Center Analysis

Antibiotics

卷:10

Peter Savov¹  Henning Windhagen¹  Lars-Rene Tuecking¹  Max Ettinger¹  Julia Silligmann¹  Mohamed Omar² 

[1] Department of Orthopaedic Surgery, Hannover Medical School, Diakovere Annastift, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany;

[2] Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hanover, Germany;

关键词: periprosthetic joint infection;    PJI;    single-stage revision TKA;    two-stage revision TKA;    revision risk;    rTKA;   

DOI  :  10.3390/antibiotics10101177

来源: DOAJ

【 摘 要 】

Periprosthetic joint infection (PJI) remains one of the most common causes of revision knee arthroplasty. Controversy continues to surround the proper operative technique of PJI in knee arthroplasty with single- or two-stage replacement. Significant variations are seen in the eradication rates of PJI and in implant survival rates. This detailed retrospective analysis of a single tertiary center is intended to provide further data and insight comparing single- and two-stage revision surgery. A retrospective analysis of all revision total knee arthroplasty (TKA) surgeries from 2013 to 2019 was performed and screened with respect to single- or two-stage TKA revisions. Single- and two-stage revisions were analyzed with regard to implant survival, revision rate, microbiological spectrum, and other typical demographic characteristics. A total of 63 patients were included, with 15 patients undergoing single-stage revision and 48 patients undergoing two-stage revision. The mean follow-up time was 40.7 to 43.7 months. Statistically, no difference was found between both groups in overall survival (54.4% vs. 70.1%, p = 0.68) and implant survival with respect to reinfection (71.4% vs. 82.4%, p = 0.48). Further, high reinfection rates were found for patients with difficult-to-treat organisms and low- to semi-constrained implant types, in comparison to constrained implant types. A statistically comparable revision rate for recurrence of infection could be shown for both groups, although a tendency to higher reinfection rate for single-stage change was evident. The revision rate in this single-center study was comparably high, which could be caused by the high comorbidity and high proportion of difficult-to-treat bacteria in patients at a tertiary center. In this patient population, the expectation of implant survival should be critically discussed with patients.

【 授权许可】

Unknown