The proper timing of second-stage revision in treating periprosthetic knee infection: reliable indicators and risk factors

Journal of Orthopaedic Surgery and Research
Jun FuJiying Chen

Abstract

Two-stage revision is the standard procedure for periprosthetic knee infection. But when to perform the second-stage is still under debate. We attempt to search the reliable indicators, risk factors, and proper timing for the second-stage revision. We reviewed and followed 81 infected total knee arthroplasty patients who underwent two-stage revision from January 2010 to January 2014. Our cohort included 56 males and 25 females, all patients were confirmed as PJI with the same phenotypic cultures. The average age was 64.8 ± 8.21 (range 36-78) months. The mean follow-up time was 46.5 ± 17.6 (range 12-72) months after the second-stage surgeries. The diagnostic parameters including serum C-reaction protein, erythrocyte sedimentation rate, and intraoperative frozen section at the time of re-implantation were analyzed. The spacer detention time and antibiotic treatment time were compared. Ten of them went through failed first- or second-stage surgeries. The overall success rate was 87.7%. The intraoperative frozen section is a good indicator at the time of re-implantation; the sensitivity and specificity is 90 and 83.1%. Serum CRP and ESR showed poor diagnostic value at time of re-implantation. Atypical pathogen infection, positive F...Continue Reading

References

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Citations

Sep 6, 2020·Journal of Orthopaedic Surgery and Research·Qiao JiangJi-Ying Chen
May 4, 2021·The Journal of Arthroplasty·Leanne LudwickJavad Parvizi
Aug 14, 2021·BMC Musculoskeletal Disorders·Mumingjiang YishakeRongxin He

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