Periprosthetic infection does not preclude good outcome for revision arthroplasty

Periprosthetic infection of a total knee arthroplasty (TKA) can be successfully eradicated by two-stage resection arthroplasty. However, the outcome of surgical intervention for infection is believed inferior to revision surgery for aseptic failures. We hypothesized patients having revision arthroplasty for infected TKA have worse functional outcome compared to patients having revisions arthroplasty for aseptic reasons. We prospectively studied 93 patients who underwent revision TKA, 22 of whom underwent two-stage resection arthroplasty and compared outcomes to 71 patients who had revision for aseptic reasons. Infected patients had worse baseline SF-36 physical scores (32 versus 39) and WOMAC functional scores (41 versus 31) than the noninfected group, but at 2-year followup both cohorts had similar functional outcomes. The two groups had similar baseline and postoperative WOMAC pain scores. Although infected patients had lower baseline SF-36 mental scores (50 versus 58), they achieved similar mental health at 2-year followup (66 versus 65). This data suggest infected patients benefit from revision arthroplasty and achieve functional, pain, and mental health status at 2-year followup similar to those of noninfected patients.