Use of a New Knee Prosthesis as an Articulating Spacer in Two-Stage Revision of Infected Total Knee Arthroplasty

Juul, Rasmus Vestergaard; Fabrin, Jesper; Poulsen, Klaus; Schrøder, Henrik Morville

doi:10.5792/ksrr.2016.28.3.239

Cited by 9 publications

(6 citation statements)

References 18 publications

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“…Treatment options are antibiotic pressure, debridement, single-or double-stage revision, arthrodesis, resection arthroplasty, and amputation. Revision surgery also has single-stage or double-stage revision options [134][135][136].…”

Section: Treatmentmentioning

confidence: 99%

Complications after Total Knee Arthroplasty

Ayas¹,

Kalkışım²,

Köse³

et al. 2020

Knee Surgery - Reconstruction and Replacement

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Nowadays, the incidence of knee arthritis increases with the prolongation of human life and the increase in world population. As a result, total knee arthroplasty application rates increased and surgeons gained more experience. There have also been technical advances and total knee arthroplasty operations have been performed using better implants. However, despite these developments, the number and variety of complications are increasing. In addition to performing total knee arthroplasty correctly, it is now becoming more important to recognize complications that may or may develop. Variety of complications after total knee replacement; from minor skin problems to life-threatening complications. In this review article, we aimed to investigate early and late complications during and after total knee replacement surgery.

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Section: Treatmentmentioning

confidence: 99%

Complications after Total Knee Arthroplasty

Ayas¹,

Kalkışım²,

Köse³

et al. 2020

Knee Surgery - Reconstruction and Replacement

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“…The use of autoclaved TKA components as temporary spacers was first described by Scott et al [42], and has demonstrated modest popularity with recurrence rates of between 0 and 21% [1, 4, 6, 8, 10–13, 15, 18, 21, 24, 25, 32, 37, 39]. In an effort to obviate the risk of recurrent infection arising from incomplete sterilization, and taking into account the possibility of indefinitely retained spacers, new TKA implants were introduced [3, 17, 18, 29, 43].…”

Section: Introductionmentioning

confidence: 99%

Temporary new implant spacers increase post-reimplantation total knee prosthesis survival after periprosthetic joint infection

Woon

Nguyen

Kapadia

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose Two-stage exchange arthroplasty is considered the gold standard for treatment of periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). Antibiotic cement spacers can include cement-based spacers (CBS), new components (NEW), and autoclaved components (ACL). The factors that most inluence post-reimplantation prosthesis (PRP) survival were determined. Methods A retrospective database review of patients undergoing two-stage exchange arthroplasty from 2008 to 2014 was performed. There were 85 patients, 25 patients and 30 patients in CBS, NEW and ACL groups, respectively. Patient, disease and surgical characteristics were collected and analyzed. Post-reimplantation prosthesis (PRP) survival was modeled using the Kaplan-Meier method. Cox proportional hazard modeling was then performed to identify risk factors associated with implant failure. Results Overall PRP survival was 82% in 140 unilateral TKAs. PRP survival between groups was 81%, 96% and 73% within the minimum 2-year follow-up period, respectively. There was a diference in median interval-to-reimplantation between groups (CBS, 72.0 days; NEW, 111.0 days; ACL, 84.0 days, p = 0.003). Adjusting for time-to-reimplantation, NEW spacers demonstrated greater PRP survival compared with ACL spacers (p = 0.044), and a trend towards greater survival compared with CBS spacers (p = 0.086). Excluding early failures (< 90 days), NEW spacers still demonstrated greater survival than ACL spacers (p = 0.046). Lower volume (≤ 10 within this series) surgeons tended to use more CBS spacers, while higher volume surgeons were comfortable with ACL spacers. Conclusions There was greater PRP survival with NEW spacers. NEW spacers also demonstrated an increased inter-stage interval, likely because of increased comfort and motion. There were spacer choice diferences between low-and highvolume surgeons. Level of evidence III.

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“…In the case of chronic infection after TKA, a two-stage revision arthroplasty has been recommended as a treatment. [4][5][6][7] In the first stage of revision, the femoral component removed from the patient is reused after autoclaving and applying an antibiotic-impregnated cement spacer. Proper antimicrobial treatment must be followed until the second stage of revision is performed.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of periprosthetic joint bacterial infections by culture of sonication fluid from infected implants

Kim

Mun

et al. 2019

J Orthop Surg (Hong Kong)

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This study compared the results of a culture method using sonication with those yielded by the conventional culture method, for patients with infected total knee arthroplasty (TKA). We also evaluated the usefulness of sonication for the identification of pathogens in infected TKA cases. Methods: Isolates were cultured from 13 implants that had been removed from 13 patients with infected TKA. Preoperative culture was performed on aspirated joint fluid, and during the operation, infected tissue was collected for culture. The removed prosthetic implants were cultured before and after sonication. Next, we identified the cultured bacteria using API biochemical kits and 16 S rRNA sequencing. Results: The cultures from preoperative joint fluid and intraoperative tissue were positive in 9 of 13 cases (69.2%). For the removed implants, 10 cases were positive before sonication. After sonication, 12 cases (92.3%) had positive cultures. The pathogen most commonly isolated from the cultures was Staphylococcus aureus. Conclusions: This study found that a culturing workflow incorporating sonication diagnosed pathogens in patients with infected TKA with higher sensitivity than did the conventional culturing method.

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Use of a New Knee Prosthesis as an Articulating Spacer in Two-Stage Revision of Infected Total Knee Arthroplasty

Cited by 9 publications

References 18 publications

Complications after Total Knee Arthroplasty

Complications after Total Knee Arthroplasty

Temporary new implant spacers increase post-reimplantation total knee prosthesis survival after periprosthetic joint infection

Diagnosis of periprosthetic joint bacterial infections by culture of sonication fluid from infected implants

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