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Outcome of a Second Two-stage Reimplantation for Periprosthetic Knee Infection

  • Symposium: Papers Presented at the 2008 Meeting of the Musculoskeletal Infection Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Recurrent or persistent infection after two-stage exchange arthroplasty for previously infected total knee replacement is a challenging clinical situation. We asked whether a second two-stage procedure could eradicate the infection and preserve knee function. We evaluated 18 selected patients with failed two-stage total knee arthroplasty implantation treated with a second two-stage reimplantation between 1999 and 2005. Failure of treatment was defined as recurrence or persistence of infection. The minimum followup was 24 months (mean, 40 months; range, 24–83 months). Recurrent or persistent infection was diagnosed in four of 18 patients, two of whom were successfully treated with a third two-stage exchange arthroplasty. Knee Society score questionnaires administered at the last followup showed an average Knee Society knee score of 73 points (range, 24–100 points) and an average functional score of 49 points (range, 20–90 points). The data suggest repeat two-stage exchange arthroplasty is a reasonable option for eradicating periprosthetic infection, relieving pain, and achieving a satisfactory level of function for some patients.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Rothman Institute, 925 Chestnut St., 5th Floor, Philadelphia, PA, 19107, USA

    Khalid Azzam MD, Kevin McHale BA, Matthew Austin MD, James J. Purtill MD & Javad Parvizi MD

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  1. Khalid Azzam MD
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  2. Kevin McHale BA
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  3. Matthew Austin MD
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  4. James J. Purtill MD
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  5. Javad Parvizi MD
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Corresponding author

Correspondence to Javad Parvizi MD.

Additional information

The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One of the authors (JP) receives payment from Stryker Orthopaedics (Mahwah, NJ) and Smith & Nephew (Memphis, TN).

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Azzam, K., McHale, K., Austin, M. et al. Outcome of a Second Two-stage Reimplantation for Periprosthetic Knee Infection. Clin Orthop Relat Res 467, 1706–1714 (2009). https://doi.org/10.1007/s11999-009-0739-4

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  • DOI: https://doi.org/10.1007/s11999-009-0739-4

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