Cargando…
Detailed Revision Risk Analysis after Single- vs. Two-Stage Revision Total Knee Arthroplasty in Periprosthetic Joint Infection: A Retrospective Tertiary Center Analysis
Periprosthetic joint infection (PJI) remains one of the most common causes of revision knee arthroplasty. Controversy continues to surround the proper operative technique of PJI in knee arthroplasty with single- or two-stage replacement. Significant variations are seen in the eradication rates of PJ...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8533002/ https://www.ncbi.nlm.nih.gov/pubmed/34680758 http://dx.doi.org/10.3390/antibiotics10101177 |
_version_ | 1784587207399440384 |
---|---|
author | Tuecking, Lars-Rene Silligmann, Julia Savov, Peter Omar, Mohamed Windhagen, Henning Ettinger, Max |
author_facet | Tuecking, Lars-Rene Silligmann, Julia Savov, Peter Omar, Mohamed Windhagen, Henning Ettinger, Max |
author_sort | Tuecking, Lars-Rene |
collection | PubMed |
description | Periprosthetic joint infection (PJI) remains one of the most common causes of revision knee arthroplasty. Controversy continues to surround the proper operative technique of PJI in knee arthroplasty with single- or two-stage replacement. Significant variations are seen in the eradication rates of PJI and in implant survival rates. This detailed retrospective analysis of a single tertiary center is intended to provide further data and insight comparing single- and two-stage revision surgery. A retrospective analysis of all revision total knee arthroplasty (TKA) surgeries from 2013 to 2019 was performed and screened with respect to single- or two-stage TKA revisions. Single- and two-stage revisions were analyzed with regard to implant survival, revision rate, microbiological spectrum, and other typical demographic characteristics. A total of 63 patients were included, with 15 patients undergoing single-stage revision and 48 patients undergoing two-stage revision. The mean follow-up time was 40.7 to 43.7 months. Statistically, no difference was found between both groups in overall survival (54.4% vs. 70.1%, p = 0.68) and implant survival with respect to reinfection (71.4% vs. 82.4%, p = 0.48). Further, high reinfection rates were found for patients with difficult-to-treat organisms and low- to semi-constrained implant types, in comparison to constrained implant types. A statistically comparable revision rate for recurrence of infection could be shown for both groups, although a tendency to higher reinfection rate for single-stage change was evident. The revision rate in this single-center study was comparably high, which could be caused by the high comorbidity and high proportion of difficult-to-treat bacteria in patients at a tertiary center. In this patient population, the expectation of implant survival should be critically discussed with patients. |
format | Online Article Text |
id | pubmed-8533002 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-85330022021-10-23 Detailed Revision Risk Analysis after Single- vs. Two-Stage Revision Total Knee Arthroplasty in Periprosthetic Joint Infection: A Retrospective Tertiary Center Analysis Tuecking, Lars-Rene Silligmann, Julia Savov, Peter Omar, Mohamed Windhagen, Henning Ettinger, Max Antibiotics (Basel) Article Periprosthetic joint infection (PJI) remains one of the most common causes of revision knee arthroplasty. Controversy continues to surround the proper operative technique of PJI in knee arthroplasty with single- or two-stage replacement. Significant variations are seen in the eradication rates of PJI and in implant survival rates. This detailed retrospective analysis of a single tertiary center is intended to provide further data and insight comparing single- and two-stage revision surgery. A retrospective analysis of all revision total knee arthroplasty (TKA) surgeries from 2013 to 2019 was performed and screened with respect to single- or two-stage TKA revisions. Single- and two-stage revisions were analyzed with regard to implant survival, revision rate, microbiological spectrum, and other typical demographic characteristics. A total of 63 patients were included, with 15 patients undergoing single-stage revision and 48 patients undergoing two-stage revision. The mean follow-up time was 40.7 to 43.7 months. Statistically, no difference was found between both groups in overall survival (54.4% vs. 70.1%, p = 0.68) and implant survival with respect to reinfection (71.4% vs. 82.4%, p = 0.48). Further, high reinfection rates were found for patients with difficult-to-treat organisms and low- to semi-constrained implant types, in comparison to constrained implant types. A statistically comparable revision rate for recurrence of infection could be shown for both groups, although a tendency to higher reinfection rate for single-stage change was evident. The revision rate in this single-center study was comparably high, which could be caused by the high comorbidity and high proportion of difficult-to-treat bacteria in patients at a tertiary center. In this patient population, the expectation of implant survival should be critically discussed with patients. MDPI 2021-09-27 /pmc/articles/PMC8533002/ /pubmed/34680758 http://dx.doi.org/10.3390/antibiotics10101177 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Tuecking, Lars-Rene Silligmann, Julia Savov, Peter Omar, Mohamed Windhagen, Henning Ettinger, Max Detailed Revision Risk Analysis after Single- vs. Two-Stage Revision Total Knee Arthroplasty in Periprosthetic Joint Infection: A Retrospective Tertiary Center Analysis |
title | Detailed Revision Risk Analysis after Single- vs. Two-Stage Revision Total Knee Arthroplasty in Periprosthetic Joint Infection: A Retrospective Tertiary Center Analysis |
title_full | Detailed Revision Risk Analysis after Single- vs. Two-Stage Revision Total Knee Arthroplasty in Periprosthetic Joint Infection: A Retrospective Tertiary Center Analysis |
title_fullStr | Detailed Revision Risk Analysis after Single- vs. Two-Stage Revision Total Knee Arthroplasty in Periprosthetic Joint Infection: A Retrospective Tertiary Center Analysis |
title_full_unstemmed | Detailed Revision Risk Analysis after Single- vs. Two-Stage Revision Total Knee Arthroplasty in Periprosthetic Joint Infection: A Retrospective Tertiary Center Analysis |
title_short | Detailed Revision Risk Analysis after Single- vs. Two-Stage Revision Total Knee Arthroplasty in Periprosthetic Joint Infection: A Retrospective Tertiary Center Analysis |
title_sort | detailed revision risk analysis after single- vs. two-stage revision total knee arthroplasty in periprosthetic joint infection: a retrospective tertiary center analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8533002/ https://www.ncbi.nlm.nih.gov/pubmed/34680758 http://dx.doi.org/10.3390/antibiotics10101177 |
work_keys_str_mv | AT tueckinglarsrene detailedrevisionriskanalysisaftersinglevstwostagerevisiontotalkneearthroplastyinperiprostheticjointinfectionaretrospectivetertiarycenteranalysis AT silligmannjulia detailedrevisionriskanalysisaftersinglevstwostagerevisiontotalkneearthroplastyinperiprostheticjointinfectionaretrospectivetertiarycenteranalysis AT savovpeter detailedrevisionriskanalysisaftersinglevstwostagerevisiontotalkneearthroplastyinperiprostheticjointinfectionaretrospectivetertiarycenteranalysis AT omarmohamed detailedrevisionriskanalysisaftersinglevstwostagerevisiontotalkneearthroplastyinperiprostheticjointinfectionaretrospectivetertiarycenteranalysis AT windhagenhenning detailedrevisionriskanalysisaftersinglevstwostagerevisiontotalkneearthroplastyinperiprostheticjointinfectionaretrospectivetertiarycenteranalysis AT ettingermax detailedrevisionriskanalysisaftersinglevstwostagerevisiontotalkneearthroplastyinperiprostheticjointinfectionaretrospectivetertiarycenteranalysis |