Prosthetic knee infection by resistant bacteria: the worst-case scenario

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
Michele VassoGiorgio Gasparini

Abstract

The aim of the present paper was to determine (1) the incidence of failure (defined as the persistence or the recurrence of the infection), (2) the incidence of prosthesis (or even limb) loss (defined as the final need for an arthrodesis, resection arthroplasty or amputation) and (3) what factors could influence the failure in patients treated with a two-stage reimplantation for periprosthetic knee infections caused by resistant bacteria. The authors retrospectively reviewed 29 total knee arthroplasties infected by resistant bacteria in 29 patients who underwent a two-stage revision. Between the stages, intravenous-targeted antibiotics were administered for a median period of 8 (range 6-12) weeks. Median follow-up was 10 (range 7-14) years. The authors found that failure occurred in 5 of 29 patients (17.2 %). When methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (MR-CoNS) were involved, failure rate was 10 % (2 of 20). When vancomycin-resistant enterococcus (VRE), multidrug-resistant (MDR) Acinetobacter baumannii and MDR Pseudomonas aeruginosa were involved, the failure rate was 33.3 % (3 of 9). Of those five patients, two underwent amputations, one chronic suppressiv...Continue Reading

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Citations

Jul 13, 2016·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Michele VassoAlfredo Schiavone Panni
Sep 8, 2016·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·A Schiavone PanniM Vasso
Jul 6, 2017·The Journal of Infection·Ilker UçkayDidier Pittet
Sep 5, 2018·Clinical Orthopaedics and Related Research·Si Young SongDerek F Amanatullah
Dec 21, 2018·Journal of Materials Chemistry. B, Materials for Biology and Medicine·Jiangjun LiuShaoqi Tian
Jul 30, 2021·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·Michele MercurioOlimpio Galasso

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