Arthrodesis after Infected Revision TKA: Retrospective Comparison of Intramedullary Nailing and External Fixation

Iacono, Francesco; Francesco, Raspugli Giovanni; Bruni, Danilo; Mirco, Lo Presti; Sharma, Bharat; Akkawi, Ibrahim; Marcacci, Maurilio

doi:10.1007/s11420-013-9349-5

Cited by 24 publications

(7 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Actually, an excess rate of re-infection after IM nail arthrodesis became evident once outlier studies were dropped off from the meta-analysis. Increased risk of recurrent infection with IM nailing as compared to EF arthrodesis has been previously reported [ 9 , 10 ], even though this finding is not supported by one recent meta-analysis [ 11 ]. Overall, these results suggest caution if the use of IM nailing is planned in difficult-to-treat PJIs (i.e.…”

Section: Discussionmentioning

confidence: 95%

“…The remaining 26 articles [ 5 , 10 , 12 , 13 , 16 – 37 ] were included in the meta-analysis. Two of these [ 10 , 22 ] were retrospective studies comparing outcomes of nail and EF arthrodesis. Hence, data from 18 and 10 studies were used for the assessment of surgical results of knee arthrodesis with IM nail and EF, respectively (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The inclusion criteria led these authors to select 12 comparative studies for the analysis, none of which was a randomized trial. Only two of these studies [ 10 , 22 ] were used in our meta-analysis in that remaining studies did not fulfilled our stringent exclusion criteria because of methodological issues (e.g. mixed diagnosis and surgical strategy, small sample size, short follow-up period etc.).…”

Section: Discussionmentioning

confidence: 99%

“…With the numbers available, no differences in fusion rate emerged between long and short periarticular nails. Several recent studies reporting results of modular IM implants disregarded bony union as an endpoint since it was not considered essential to obtain successful outcome [ 5 , 10 , 12 , 23 , 26 , 29 , 33 ]. Conversely, bony union is of outmost importance for EF arthrodesis.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Re-infection rates and clinical outcomes following arthrodesis with intramedullary nail and external fixator for infected knee prosthesis: a systematic review and meta-analysis.

Balato

Rizzo

Ascione

et al. 2018

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundKnee arthrodesis with intramedullary (IM) nail or external fixator (EF) is the most reliable therapeutic option to achieve definitive infection control in patients with septic failure of total knee arthroplasty (TKA). The first aim of this study was to compare re-infection rates following knee arthrodesis for periprosthetic joint infection (PJI) with IM nail or EF. The second aim was to compare rates of radiographic union, complication, and re-operation as well as clinical outcomes.MethodsA systematic search was performed in electronic databases for longitudinal studies of PJIs (minimum ten patients; minimum follow-up = 1 year) treated by knee arthrodesis with IM nail or EF. Studies were also required to report the rate of re-infection as an outcome measure. Eligible studies were meta-analyzed using random-effect models.ResultsThe rate (95% confidence intervals) of re-infection was 10.6% (95% CI 7.3 to 14.0) in IM nail arthrodesis studies. The corresponding re-infection rate for EF was 5.4% (95% CI 1.7 to 9.1). This difference was significant (p = 0.009). The use of IM nail resulted in more advantages than EF for frequency of major complications and limb shortening. Other postoperative clinical and radiographic outcomes were similar for both surgical strategies.ConclusionsThe available evidence from the aggregate published data suggests that knee arthrodesis with EF in the specific context of PJI has a reduced risk of re-infection in comparison with the IM nail strategy. The use of IM nail is more effective for the complication rate and shortening of the affected limb.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Re-infection rates and clinical outcomes following arthrodesis with intramedullary nail and external fixator for infected knee prosthesis: a systematic review and meta-analysis.

Balato

Rizzo

Ascione

et al. 2018

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…[85] found that functional outcome scores and LLD were significantly better in the IMN group but with higher rates of persistent infection. There was no significant difference in pain scores between both groups [85]. Van Rensch et al .…”

Section: Methodsmentioning

confidence: 99%

Salvage Procedures for Management of Prosthetic Joint Infection After Hip and Knee Replacements

Mahmoud¹,

Sukeik²,

Alazzawi³

et al. 2016

TOORTHJ

View full text Add to dashboard Cite

Background:The increasing load placed by joint replacement surgery on health care systems makes infection, even with the lowest rates, a serious concern that needs to be thoroughly studied and addressed using all possible measures.Methods:A comprehensive review of the current literature on salvage procedures for recurrent PJIs using PubMed, EMBASE and CINAHL has been conducted.Results:Prolonged suppressive antibiotic therapy (PSAT), resection arthroplasty and arthrodesis were the most common procedures performed. Suppressive antibiotic therapy is based on the use of well tolerated long term antibiotics in controlling sensitive organisms. Resection arthroplasty which should be reserved as a last resort provided more predictable outcomes in the hip whereas arthrodesis was associated with better outcomes in the knee. Various methods for arthrodesis including internal and external fixation have been described.Conclusion:Despite good union and infection control rates, all methods were associated with complications occasionally requiring further surgical interventions.

show abstract

Diagnosing the Infected Total Knee Arthroplasty

Tohidi

Rudan

2021

Evidence‐Based Orthopedics

View full text Add to dashboard Cite

Arthrodesis after Infected Revision TKA: Retrospective Comparison of Intramedullary Nailing and External Fixation

Cited by 24 publications

References 31 publications

Re-infection rates and clinical outcomes following arthrodesis with intramedullary nail and external fixator for infected knee prosthesis: a systematic review and meta-analysis.

Re-infection rates and clinical outcomes following arthrodesis with intramedullary nail and external fixator for infected knee prosthesis: a systematic review and meta-analysis.

Salvage Procedures for Management of Prosthetic Joint Infection After Hip and Knee Replacements

Diagnosing the Infected Total Knee Arthroplasty

Contact Info

Product

Resources

About