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Survival analysis of one-stage exchange of infected unicompartmental knee arthroplasty: a single-center study with minimum 3 years follow-up

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The rates of unicompartmental knee arthroplasty (UKA) are increasing yet little data exists regarding management of periprosthetic joint infections (PJI) after UKA, particularly utilizing one-stage revision. The aim of this study was to determine the septic and all-cause revision-free survival of UKA PJIs treated with one-stage revision, as well as functional outcomes and risk factors for failure.

Methods

A retrospective review of one-stage septic revisions with a hinged or rotating hinged implant between 2000 and 2015 at a single institution was performed. Results of 15 patients with a minimum of 3-year follow-up (mean = 93 months; range 37–217) were evaluated by means of infection control, survivorship, patient reported functional score and possible causal factors for a re-revision. Kaplan–Meier curves and Cox regression analysis were used.

Results

After a mean of 8 years of follow-up infection control rate was 93.3%, the survivorship free of any reoperation, including both septic and aseptic causes, was 80% at 5 years and 64.2% at ten years and average Lysholm score was 72.7 ± 21.3 (33–100).

Conclusion

One-stage revision for PJI of UKA using a hinged knee design has excellent infection-free survival at mid to long-term follow-up. Likewise, patient reported functional outcomes are promising. However, one-third of patients required aseptic reoperation and aseptic loosening was the dominant etiology.

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Author information

Author notes

  1. Hakan Kocaoğlu and Fabian Hennes contributed equally as first author, so they should be indicated as co-first author.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Germany

    Hakan Kocaoğlu, Fabian Hennes, Hussein Abdelaziz, Michael E. Neufeld, Thorsten Gehrke & Mustafa Citak

  2. Department of Orthopaedics and Traumatology, Faculty of Medicine, Ankara University, Ibn-i Sina Hospital Talatpasa Blvd, 06100, Ankara, Turkey

    Hakan Kocaoğlu

  3. Zentrum für Rehabilitationmedizin/Sportmedizin, BG Klinikum Hamburg, Bergerdorfer Strasse 10, 21033, Hamburg, Germany

    Fabian Hennes

  4. Division of Lower Limb Reconstruction, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada

    Michael E. Neufeld

Authors
  1. Hakan Kocaoğlu
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  2. Fabian Hennes
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  6. Mustafa Citak
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by HK, FH and MÇ. The first draft of the manuscript was written by HK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hakan Kocaoğlu.

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Conflict of Interest

Author Hakan Kocaoğlu, Fabian Hennes, Hussein Abdelaziz and Michael Neufeld declare they have no financial interests. Author Mustafa Çıtak has received speaker and consultant honoraria from Waldemar Link, Hamburg, Germany. Author Thorsten Gehrke has received speaker honorarium and paid consultant fee from Waldemar Link, Hamburg, Germany; Zimmer Biomet, Warsaw, USA; Ceramtec, Pochingen, Germany and Heraus, Hanau, Germany.

Ethical standard

We hereby confirm that all procedures performed in studies involving human participants were in accordance with the ethical standards of the regional ethics committee (Ethik-Kommission der Arztekammer Hamburg, Deutschland; PV 5647; 2019) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Kocaoğlu, H., Hennes, F., Abdelaziz, H. et al. Survival analysis of one-stage exchange of infected unicompartmental knee arthroplasty: a single-center study with minimum 3 years follow-up. Eur J Orthop Surg Traumatol 33, 327–333 (2023). https://doi.org/10.1007/s00590-021-03187-7

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