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Periprosthetic Knee Infection – Part 2: Treatment

Several treatment modalities are proposed for periprosthetic infections, with variable success rates. However, efficacy is related to the appropriate selection of cases for each type of treatment. Debridement with implant retention is indicated in acute infections with fixed implant, and its success...

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Detalles Bibliográficos
Autores principales: Barretto, João Maurício, Campos, André Luiz Siqueira, Ooka, Nelson Hiroyuki Miyabe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Revinter Publicações Ltda. 2022
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142269/
https://www.ncbi.nlm.nih.gov/pubmed/35652024
http://dx.doi.org/10.1055/s-0041-1729936
Descripción
Sumario:Several treatment modalities are proposed for periprosthetic infections, with variable success rates. However, efficacy is related to the appropriate selection of cases for each type of treatment. Debridement with implant retention is indicated in acute infections with fixed implant, and its success depends on the type of infection, comorbidities of the host, and virulence of the etiological agent. One- or two-stage revision is required in cases in which biofilm is forming, or of implant loosening. The choice between performing the review in one or two stages depends on factors such as etiological agent identification, pathogen virulence, local and systemic host factors. Rescue procedures such as arthrodesis, amputation, resection arthroplasty or even antibiotic suppression are reserved for cases in which the infection has not been eradicated.