Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 21, Issue 12, pp 2713–2720 | Cite as

Patient reported outcome measures after revision of the infected TKR: comparison of single versus two-stage revision

  • Paul Baker
  • Timothy G. Petheram
  • Steven Kurtz
  • Yrjö T. Konttinen
  • Paul Gregg
  • David Deehan
Knee

Abstract

Purpose

Two-stage revision is the ‘gold standard’ treatment for infected total knee replacement. Single-stage revision has been successful in the hip and, in carefully chosen knee revisions, may offer the advantage of a single surgical insult with improved functional outcome.

Methods

Patient Reported Outcome Measures (PROMs) for 33 single- and 89 two-stage revisions performed for infection were analysed in combination with data from the National Joint Registry for England and Wales. Outcomes including the Oxford Knee Score (OKS), Euroqol-5D (EQ5D) and patient satisfaction were examined with the aim of investigating the following questions: does single- or two-stage revision for infection result in (1) better knee function; (2) better overall perception of health status; (3) better patient perceived success and satisfaction?

Results

No statistical difference was found between the groups for any reported outcome measure. Mean OKS following surgery was 24.9 (95 %CI, 20.5–29.4) for single- and 22.8 (95 %CI, 20.2–25.4) for two-stage (n.s.). Mean EQ5D index following surgery was 0.495 (95 %CI, 0.357–0.632) for single and 0.473 (95 %CI, 0.397–0.548) for two-stage (n.s.). Patients reporting Excellent/Very good/Good satisfaction were similar between the groups (single = 61 % vs. two stage = 57 %, (n.s.)). In total, 66 % single- and 60 % two-stage operations were rated ‘successful’ (n.s.).

Conclusions

This study found no demonstrable benefit of single-stage compared to two-stage revision for the infected total knee replacement using a variety of PROMs. Thus, we recommend that decision making must be based on other factors such as re-infection rate.

Level of evidence

IV.

Keywords

Infection Revision Single stage Two stage Knee arthroplasty Outcomes 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Paul Baker
    • 1
  • Timothy G. Petheram
    • 2
  • Steven Kurtz
    • 3
  • Yrjö T. Konttinen
    • 4
  • Paul Gregg
    • 5
  • David Deehan
    • 6
  1. 1.Institute of Cellular MedicineUniversity of NewcastleNewcastle upon TyneUK
  2. 2.Wansbeck General HospitalAshington, NorthumberlandUK
  3. 3.Philadelphia Office, ExponentPhiladelphiaUSA
  4. 4.Department of MedicineInstitute of Clinical MedicineHelsinki (HUS)Finland
  5. 5.Department of Orthopaedic SurgeryJames Cook University HospitalMiddleboroughUK
  6. 6.Department of Orthopaedic SurgeryRoyal Victoria InfirmaryNewcastle upon TyneUK

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