Deep sepsis following total knee arthroplasty. Ten-year experience at the University of California at Los Angeles Medical Center.

Grogan, Thomas J.; Dorey, Fred; Rollins, James; Amstutz, Harlan C.

doi:10.2106/00004623-198668020-00008

Cited by 189 publications

(54 citation statements)

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“…Their final outcome included 10 knees treated successfully with arthrodesis, five knees treated with suppressive antibiotics (four of these knees failed suppressive therapy), four above-theknee amputations, three persistent pseudarthroses of the knee, one resection arthroplasty, and one uninfected prosthesis. Our experience of antibiotic suppression alone was poor, and this was reflected in the literature [17,31,52]. This method did not treat the infection definitively and only suppressed it, making it a treatment option only for patients who are not good surgical candidates for two-stage revision TKA.…”

Section: Discussionmentioning

confidence: 99%

“…The rate of periprosthetic infection has been declining over the last two to three decades, mostly due to operating room environments and operative techniques [17,27,40]. Various methods have been used in the initial treatment of periprosthetic knee infection, including irrigation and debridement [10,11,38], direct exchange arthroplasty [6,16], and two-stage revision TKA with subsequent reimplantation [15,18].…”

Section: Introductionmentioning

confidence: 99%

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Assessing the Gold Standard: A Review of 253 Two-Stage Revisions for Infected TKA

Mahmud

Lyons

Naudie

et al. 2012

Clinical Orthopaedics &Amp; Related Research

124

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Background Periprosthetic joint infection has been the leading cause of failure following TKA surgery. The gold standard for infection control has been a two-staged revision TKA. There have been few reports on mid-to longterm survivorship, functional outcomes, and fate of patients with a failed two-stage revision TKA. Questions/purposes Therefore, we determined (1) the mid-term survivorship of two-stage revision TKA, (2) the function of patients in whom infection was controlled, and (3) the outcome of patients with a failed two-stage revision due to recurrent infection. Methods We retrospectively reviewed 239 patients who underwent 253 two-stage revision TKAs for periprosthetic infection. There were 239 patients (253 knees), 104 men and 135 women, with a mean age of 70 ± 10 years at the time of two-stage revision and a mean BMI of 31.53 ± 6.74 kg/m 2 . During followup, we obtained WOMAC and The Knee Society Clinical Rating Scores and radiographs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessing the Gold Standard: A Review of 253 Two-Stage Revisions for Infected TKA

Mahmud

Lyons

Naudie

et al. 2012

Clinical Orthopaedics &Amp; Related Research

124

View full text Add to dashboard Cite

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“…Onethird of infections arise as a result of hematogenous seeding of the joint during the first 2 years after the procedure [10,16,42]. UTI is a common hospital-acquired infection that creates a potential reservoir of resistant pathogens and increases patient morbidity [43,45,47,50,51].…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty

Koulouvaris¹,

Sculco²,

Finerty³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Surgical wound infection is a serious and potentially catastrophic complication after joint arthroplasty. Urinary tract infection is a common infection that creates a potential reservoir of resistant pathogens and increases patient morbidity. We asked whether treated preoperative and postoperative urinary tract infections are risk factors for deep joint infection. We examined the medical records of 19,735 patients. The minimum had joint infections develop. Of these, three had preoperative and four had postoperative urinary tract infections. The majority of bacteria were not enteric. The bacteria in the two types of infections were not identical. Control subjects were randomly selected from a list of patients matched with patients having infections. Of these, eight had preoperative and one had postoperative urinary tract infections. We found no association between the preoperative urinary tract infection (odds ratio, 0.341; 95% confidence interval, 0.086-1.357) or postoperative urinary tract infection (odds ratio, 4.222; 95% confidence interval, 0.457-38.9) and wound infection. Only one of the 58 patients with wound infections had a urinary tract infection with the same bacteria in both infections. Given the infection rate was very low (0.29%), the power of the study was only 25%. Although limited, the data suggest patients with urinary tract infections had no more likelihood of postoperative infection. We believe treated urinary tract infection should not be a reason to delay or postpone surgery. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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“…Nowadays, infections of hip and knee prostheses occur in 1-2% of patients who have primary hip and knee arthroplasties [2,5,8,12,13]. Infection of prostheses is generally more common after primary knee arthroplasty than after hip arthroplasty -probably due to the more superficial location of the former [6].…”

Section: Introductionmentioning

confidence: 99%

The outcome of perioperative wound infection after total hip and knee arthroplasty

Abudu

Sivardeen

Grimer

et al. 2001

International Orthopaedics (SICOT)

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Forty-one consecutive patients with primary knee arthroplasty and 37 with primary hip arthroplasty, all with perioperative wound infections, were followed for 50 (12-130) months. Staphylococci (coagulase negative and positive) accounted for 74% of wound infections. Mixed organisms accounted for 10%. Prosthetic infections developed in eight patients and aseptic loosening in three patients. All the prosthetic infections developed within 6 months of the primary surgery. Organisms responsible for superficial infections were responsible for prosthetic infection in five patients; no organisms were isolated in the remaining three patients. The presence or absence of wound dehiscence, wound haematoma, and postoperative pyrexia did not predict the development of deep sepsis; however, the presence of wound discharge was a significant risk factor. Résumé Une série de patients consécutifs présentant une infection péri-opératopire ont été suivis pendant 50 (12 à 130) mois ; 41 après une arthroplastie primaire du genou et 37 après une arthroplastie primaire de la hanche. Le staphylocoque (coagulase positif et negatif) était en cause dans 74% des cas. Dans 10% des cas plusieurs germes étaient en cause. Les infections sur prothèse se sont développées chez huit patients et il y eu un descellement aseptique chez trois patients. Toutes les infections sur prothèse se sont développées dans les six mois suivant la chirurgie primaire. Les germes responsables des infections superficielles étaient responsables de l'infection sur prothèse chez cinq patients. Aucun germe n'a été isolé chez les trois autre patients. La présence d'une déhiscence de la plaie, l'existence d'un hématome ou la pyrexie postopératoires n'avaient pas de valeur prédictive pour le développement d'un sepsis profond mais la présence d'un écoulement de la plaie opératoire était un facteur de risque considérable.

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Deep sepsis following total knee arthroplasty. Ten-year experience at the University of California at Los Angeles Medical Center.

Cited by 189 publications

References 0 publications

Assessing the Gold Standard: A Review of 253 Two-Stage Revisions for Infected TKA

Assessing the Gold Standard: A Review of 253 Two-Stage Revisions for Infected TKA

Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty

The outcome of perioperative wound infection after total hip and knee arthroplasty

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