Debridement with prosthesis retention and antibiotherapy vs. two-stage revision for periprosthetic knee infection within 3 months after arthroplasty: a case–control study

Abstract

Sixty-four patients with periprosthetic infection within 3 months of index arthroplasty, of whom 39 underwent debridement with prosthesis retention and antibiotherapy (DPRA), and 25 underwent two-stage revision (2SR), were compared regarding control of infection and functional outcomes by use of Knee Society scores. Failure was defined as the need for subsequent surgery to control infection. The failure rate after DPRA was 61.5%, and that after 2SR was 12.0% (p 0.001). The failure risk was not significantly associated with the duration of symptoms (≤4 weeks). The only predictor of failure was isolation of Staphylococcus aureus or Staphylococcus epidermidis. Treatment with 2SR required fewer surgical operations, a shorter duration of hospitalization, and a shorter duration of treatment. All patients who required a second debridement ultimately underwent prosthesis removal. The functional outcome was significantly better for 2SR at the last follow-up.

Debridement, antibiotics, and implant retention for periprosthetic knee infections: a pooling analysis of 1266 cases

“…Multiple debridements were chosen in ten studies if a single debridement fail [14, 17, 18, 20, 28, 29, 32–34, 43]. The success rate of a single debridement and multiple debridements was 57.23% (190/332 cases, 95% CI: 51.9–62.6) and 49.25% (33/67 cases, 95% CI: 37.0–61.5), respectively.…”

The infection of Mycoplasma hominis after total knee replacement: Case report and literature review

“… 6 It is commonly treated by antibiotic treatment combined with open wound debridement as illustrated in many literature. 7 , 8 , 9 , 10 However, the success rate is in general less than 60%, 11 a relatively low percentage. Peersman et al.…”

Hot spots and trends in knee revision research since the 21st century: a bibliometric analysis

“…However, with the development of clinic technique, there are increasing doubts on the drawbacks, such as twice operations at least, poor functional activities between the two stages and more costs. Based on that, new treatment methods were applied and the curative effects were observed, for example, debridement with prosthesis retention and anti-biotherapy (14). However, different treatment methods have their unique advantages.…”