Abstract
Background and Purpose: Two-stage revision remains the gold standard in the treatment of infected knee arthroplasty. The purpose of this study was to evaluate the clinical results of two-stage reimplantation of an infected total knee arthroplasty using an articulating antibiotic-impregnated cement spacer.
Materials and Methods: We studied 34 patients who had undergone two-stage revision TKA for infection from 2001 to 2006. The average age of the patients was 72,7 years. The minimum followup was 25 months (mean 38 months, range, 25–94 months).
After the first stage a 10-week antibiotic course was administered according to the sensitivity of the isolated bacterial strain. The second stage procedure was carried out after 4,9 months.
Results: The overall failure rate in eradication of infection was 14,7% (5/34), being the S. Epidermidis isolated in 2 cases; and coagulase-negative staphylococcus, Corynebacterium and Enterococcus isolated in 1 case each. We had 13 complications: 2 patients suffered infection caused by a pathogen different from the original, 4 patients underwent knee arthrodesis in their second stage, 1 patellar luxation, 1 asseptical loosening, 1 patient received amputation dued vascular insuficiency, 2 patients needed skin flap transplantation, 2 patients died before the second stage was done.
Conclusion: Two-stage reimplantation with an articulating spacer for infected TKA effectively treats infection and facilitates the second stage. In our opinion the high rate of complications must be expected and justified by the complexity of the patients and the type of microorganism.
Correspondence should be addressed to Vienna Medical Academy, Alser Strasse 4, A-1090 Vienna, Austria. Phone: +43 1 4051383 0, Fax: +43 1 4078274, Email: ebjis2009@medacad.org
