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

被引:16
|
作者
Tuecking, Lars-Rene [1 ]
Silligmann, Julia [1 ]
Savov, Peter [1 ]
Omar, Mohamed [2 ]
Windhagen, Henning [1 ]
Ettinger, Max [1 ]
机构
[1] Hannover Med Sch, Dept Orthopaed Surg, Anna Von Borries Str I-7, D-30625 Hannover, Germany
[2] Hannover Med Sch, Dept Trauma Surg, Carl Neuberg Str 1, D-30625 Hannover, Germany
来源
ANTIBIOTICS-BASEL | 2021年 / 10卷 / 10期
关键词
periprosthetic joint infection; PJI; single-stage revision TKA; two-stage revision TKA; revision risk; rTKA; STAGE EXCHANGE;
D O I
10.3390/antibiotics10101177
中图分类号
R51 [传染病];
学科分类号
100401 ;
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.
引用
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页数:14
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