IRCCS Istituto Ortopedico Galeazzi, Center for Reconstructive Surgery and Osteoarticular Infections, Milan, Italy.
IRCCS Istituto Ortopedico Galeazzi, Sport Traumatology and Minimally Invasive Surgery Center, Milan, Italy.
Expert Rev Anti Infect Ther. 2021 Jul;19(7):945-948. doi: 10.1080/14787210.2021.1851597. Epub 2020 Dec 3.
We conducted a retrospective study to evaluate the outcomes of one-stage revision total knee arthroplasty (TKA) in terms of eradication of the infection, improvement of pain, and knee function.
Between 2009 and 2016, 20 patients underwent one-stage revision TKA for the treatment of a prosthetic joint infection (PJI). Inclusion criteria were: patients nonimmunocompromised with minimal or moderate bone loss, known organisms with known sensitivity. Assessment included clinical signs of infection eradication, range of motion, Knee Society clinical rating score, visual analog scale pain score, and radiographic assessment.
After a mean follow-up of 6.2 years (range, 2-10 years), none of the patients had signs suggesting recurrent infection. Follow-up examination showed significant improvement of all variables compared to preoperative values (p < 0.001).
One-stage revision surgery provides infection eradication and satisfying subjective functional outcomes for infected knee arthroplasty in selected patients.
One-stage revision knee arthroplasty is a valuable resource to approach PJIs in selected patients whose infecting micro-organism and sensitivity are determined before surgery. In order to succeed strict inclusion criteria should be applied, as only non-immunocompromised patients with healthy soft tissues with minimal or moderate bone loss are eligible for this procedure.
我们进行了一项回顾性研究,以评估一期翻修全膝关节置换术(TKA)在消除感染、改善疼痛和膝关节功能方面的疗效。
2009 年至 2016 年间,20 例患者因假体关节感染(PJI)接受一期翻修 TKA 治疗。纳入标准为:非免疫功能低下、骨质丢失少或中度、已知病原体和药敏的患者。评估包括感染消除的临床体征、活动范围、膝关节学会临床评分、视觉模拟评分疼痛和影像学评估。
平均随访 6.2 年(范围,2-10 年)后,所有患者均无感染复发迹象。随访检查显示,所有变量与术前值相比均有显著改善(p<0.001)。
一期翻修手术可有效消除感染,并为选定患者的感染性膝关节置换提供满意的主观功能结果。
在术前确定感染微生物和药敏的情况下,一期翻修膝关节置换术是治疗特定患者 PJI 的一种有价值的方法。为了获得成功,应严格应用纳入标准,只有非免疫功能低下、软组织健康、骨质丢失少或中度的患者才能进行此手术。