Short-interval two-stage approach to primary total knee arthroplasty for acutely septic osteoarthritic knees

Hochreiter, Bettina; Strahm, Carol; Behrend, Henrik

doi:10.1007/s00167-016-3982-8

Cited by 11 publications

(15 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Classically, this patient population has been treated with 2-stage arthroplasty [10,12,13,30,31]. Indeed, in our series, the patients who received two-stage treatment have demonstrated a 100% survivorship rate.…”

Section: Discussionmentioning

confidence: 75%

Articulating vs Static Spacers for Native Knee Infection in the Setting of Degenerative Joint Disease

et al. 2021

View full text Add to dashboard Cite

Background: Patients with advanced knee arthritis who develop a septic joint are not adequately treated with irrigation and debridement and intravenous antibiotics because of antecedent cartilage damage. The gold standard treatment has been a 2-stage approach. The periprosthetic joint infection literature has demonstrated the superiority of articulating spacers, and metal-on-poly (MOP) spacers are being used with increasing frequency. The purpose of this study was to compare the postoperative outcomes of patients with infected, arthritic knees treated by a 2-stage approach to those of patients who received single-stage treatment with a MOP spacer. Methods: Sixteen patients with native knee septic arthritis treated with an antibiotic spacer between 1998 and 2019 were reviewed. Demographic data, clinical data, knee motion, Knee Society score, Timed-Up-and-Go, and pain scores were collected. Survivorship of final implants was compared. Results: Six of 16 knees (38%) received single-stage treatment, and 10 received 2-stage treatment (62%). Five of 6 MOP spacers (83%) were retained at a mean follow-up of 3 ± 1.2 years. Nine of 10 (90%) receiving static spacers had subsequent reconstruction, with 9 (100%) surviving at mean follow-up of 7 ± 3.2 years. The patients who received MOP spacers trended toward greater terminal flexion, higher Knee Society score, and faster Timed-Up-and-Go at final follow-up. Conclusion: Infection in a native, arthritic knee may be effectively treated using single-stage MOP spacer. Postoperative outcomes of single-stage MOP spacers compare favorably to staged static spacers and with those undergoing revision surgery for other indications. Longer follow-up is needed to evaluate durability of MOP spacers.

show abstract

Section: Discussionmentioning

confidence: 75%

Articulating vs Static Spacers for Native Knee Infection in the Setting of Degenerative Joint Disease

et al. 2021

View full text Add to dashboard Cite

show abstract

“…However, the effect of the above treatments on advanced infectious arthritis is very poor, yet there is no established guidelines for such conditions, especially in the demanding adults. Though limited therapeutic options, there were several researches put effects on applying two-stage approach to primary TKA and tried to improve the e ciency 2,3,11,20 . In our study, demands in eliminating infection, relieving symptoms and returning function were ful lled, Also, we reported similar experience and endings as previous studies, though with small sample size.…”

Section: Discussionmentioning

confidence: 99%

Two-Stage Total Knee Arthroplasty in the Treatment of Advanced Knee Septic Arthritis: Case Series

Wang¹,

Teng²,

Wang³

et al. 2021

Preprint

View full text Add to dashboard Cite

PURPOSE: Septic arthritis (SA) is defined as the joint inflammation secondary to bacterial infection with a potentially fatal condition, but with no established approach treatment currently. Two-stage primary total knee arthroplasty (TKA) with an antibiotic-laden cement spacer has been reported to apply to treat SA of knee effectively in individual cases. We reported our cases aimed to contribute to current information on two-stage TKA in the treatment of advanced SA in knee joint.Methods: We retrospectively screened clinical profiles of eleven patients with SA in knee joint who had two-stage TKA with an antibiotic-laden cement spacer. Information of inflammatory serological markers were summarized and statistic comparisons were done on Hospital for Special Surgery (HSS) score as well as the degree of the range of motion (ROM) between pre-, interval- and post-operation, with significant level of p<0.05.Results: Infection in knee joint was eliminated in all eleven patients by two-stage TKA with an antibiotic-laden cement spacer. CRP took 3.4 ± 1.4 weeks (range, 1-6 weeks) to return to normal level, whilst for ESR was 16.3 ± 3.0 weeks (range, 13-23 weeks). Means of HSS score and ROM degree were significantly increased after both the first and second-stage surgery (p<0.05). HSS score of three timings were not different in age, gender, micro-organism culture results and comorbidities in our study.Conclusions: Two-stage TKA is an effective treatment in SA in knee joint in controlling infection, relieving clinical severity and improving function of keen joint thereafter.Level of evidence IV.

show abstract

“…Septic arthritic knee (SAK) is a relatively low-incidence disease while it has a high risk of disability and mortality [1]. There is currently no universally agreed ideal treatment strategy, and its treatment still faces great challenges [2]. Traditional treatment methods include knee incision or arthroscopic cleaning/irrigation/drainage based on systemic antibiotic treatment [3].…”

Section: Introductionmentioning

confidence: 99%

“…For SAK cases with false infection control, rescue treatments, such as fusion and amputation, are often adopted [5,6]. In recent years, there have been occasional reports of a method similar to the second-stage revision [7][8][9][10] for the treatment of SAK, including first-stage debridement and implantation of static or articulated spacer to control infection and second-stage initial total knee replacement to restore knee function [2,5,[11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Clinical effects of staged joint replacement in patients with septic arthritic knee

Deng

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

Objective To assess the clinical effect of staged joint replacement for the treatment of septic arthritic knee and the therapeutic differences between antibiotic cement beads and the tibial plateau spacer. Methods Twenty-three patients (24 knee joints) treated with a staged joint replacement for septic arthritis knee were retrospectively reviewed between March 2014 and April 2018. At the first stage, thorough debridement and irrigation with self-made antibiotic cement beads or tibial plateau spacer were performed. After that, systemic antibiotic treatment was followed; when the infection was surely eliminated, the second-stage TKA was performed. Knee mobility (range of motion, abbreviated to ROM) and function (HSS scores system) were evaluated before surgery, in the interval period, and after joint replacement. Results All patients finished follow-up, and the mean follow-up time was 27.3 months (12–54 months). Each group has one patient replaced with a homotypic spacer, and all patients eventually cleared the infection. None of the patients had a recurrent infection. The mobility and HSS scores of the two groups were significantly improved postoperation (p < 0.05). And there was no significant difference in the post-surgery ROM (p = 0.153) and the HSS score (p = 0.054) between the two groups. Conclusion Staged joint replacement is an efficacious way for septic arthritic knees, whether tibial plateau spacer or antibiotic cement beads were used, which can effectively control infection and improve knee function.

show abstract

Short-interval two-stage approach to primary total knee arthroplasty for acutely septic osteoarthritic knees

Cited by 11 publications

References 43 publications

Articulating vs Static Spacers for Native Knee Infection in the Setting of Degenerative Joint Disease

Articulating vs Static Spacers for Native Knee Infection in the Setting of Degenerative Joint Disease

Two-Stage Total Knee Arthroplasty in the Treatment of Advanced Knee Septic Arthritis: Case Series

Clinical effects of staged joint replacement in patients with septic arthritic knee

Contact Info

Product

Resources

About

Short-interval two-stage approach to primary total knee arthroplasty for acutely septic osteoarthritic knees

Cited by 11 publications

References 43 publications

Articulating vs Static Spacers for Native Knee Infection in the Setting of Degenerative Joint Disease

Articulating vs Static Spacers for Native Knee Infection in the Setting of Degenerative Joint Disease

Two-Stage Total Knee Arthroplasty in the Treatment of Advanced&nbsp;Knee Septic Arthritis: Case Series

Clinical effects of staged joint replacement in patients with septic arthritic knee

Contact Info

Product

Resources

About

Two-Stage Total Knee Arthroplasty in the Treatment of Advanced Knee Septic Arthritis: Case Series