ABSTRACT

Objectives

We conducted a retrospective study to evaluate the outcomes of one-stage revision total knee arthroplasty (TKA) in terms of eradication of the infection, improvement of pain, and knee function.

Methods

Between 2009 and 2016, 20 patients underwent one-stage revision TKA for the treatment of a prosthetic joint infection (PJI). Inclusion criteria were: patients nonimmunocompromised with minimal or moderate bone loss, known organisms with known sensitivity. Assessment included clinical signs of infection eradication, range of motion, Knee Society clinical rating score, visual analog scale pain score, and radiographic assessment.

Results

After a mean follow-up of 6.2 years (range, 2–10 years), none of the patients had signs suggesting recurrent infection. Follow-up examination showed significant improvement of all variables compared to preoperative values (p < 0.001).

Conclusions

One-stage revision surgery provides infection eradication and satisfying subjective functional outcomes for infected knee arthroplasty in selected patients.

Expert opinion

One-stage revision knee arthroplasty is a valuable resource to approach PJIs in selected patients whose infecting micro-organism and sensitivity are determined before surgery. In order to succeed strict inclusion criteria should be applied, as only non-immunocompromised patients with healthy soft tissues with minimal or moderate bone loss are eligible for this procedure.

中文翻译：

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一期翻修手术为特定患者的感染性膝关节置换术提供了感染根除和令人满意的结果

摘要

目标

我们进行了一项回顾性研究，以评估一期翻修全膝关节置换术 (TKA) 在根除感染、改善疼痛和膝关节功能方面的结果。

方法

2009 年至 2016 年间，20 名患者接受了一期翻修 TKA 以治疗假体关节感染 (PJI)。纳入标准是：无免疫功能低下的患者，骨丢失极少或中度，已知微生物具有已知敏感性。评估包括感染根除的临床体征、运动范围、膝关节协会临床评分、视觉模拟量表疼痛评分和放射学评估。

结果

平均随访 6.2 年（范围为 2-10 年）后，所有患者均未出现提示感染复发的迹象。与术前值相比，随访检查显示所有变量都有显着改善（p < 0.001）。

结论

一期翻修手术为选定患者的感染膝关节置换术提供了感染根除和令人满意的主观功能结果。

专家意见

一期翻修膝关节置换术是在手术前确定感染微生物和敏感性的选定患者中处理 PJI 的宝贵资源。为了获得成功，应采用严格的入选标准，因为只有具有健康软组织且骨丢失极少或中度的非免疫功能低下患者才有资格进行此手术。