Septic and Reconstructive Surgery Unit, Orthopaedic and Traumatology Section, Hospital Universitari i Politècnic la Fe, Valencia, Spain.
J Arthroplasty. 2024 Feb;39(2):494-500. doi: 10.1016/j.arth.2023.08.011. Epub 2023 Aug 11.
Knee arthrodesis is a means of avoiding above-knee amputation after a prosthetic joint infection (PJI). The objective of this study was to analyze the results of floating knee arthrodesis in patients who had a history of aprosthetic knee infection. The analysis consisted of determining reinfection rates, functional results, and the survival of arthrodesis.
There were 48 patients who underwent a cemented floating knee arthrodesis in cases of PJI retrospectively included in the study, having been operated on between 2012 and 2020. In addition to being evaluated clinically, analytically, and radiographically, the patients were assessed functionally by means of a newly-created scale.
At a mean follow-up of 4 years (1 year to 9 years), 7 patients suffered reinfection (14.6%). The recurrence of infection was not observed to be significantly affected by sex (P = .16), age(P = .09), or the type of surgery previously undergone (P = .18), nor was the McPherson Host Grade (P = .4) observed to have a significant effect. Patients who had a McPherson Limb Grade 3 were more likely to suffer reinfection than those with a McPherson Limb Grade 2 (P = .034). There were 26 patients (54%)fully evaluated and scored on the Knee Arthrodesis Functional Scale(BAOR). For 11 patients (42%), the results were evaluated as excellent, for 11 (42%) acceptable, for 3 (12%) low, and for 1(4%) poor.
The arthrodesis nail is an effective and safe procedure for patients who have a recurrent PJI, providing an effective alternative when the criteria for a new revision total knee arthroplasty are not met.
膝关节融合术是避免人工关节感染（PJI）后膝关节以上截肢的一种方法。本研究的目的是分析既往存在人工膝关节感染病史的患者行漂浮膝关节融合术的结果。分析内容包括再感染率、功能结果和融合术的存活率。
回顾性纳入 2012 年至 2020 年间因 PJI 行骨水泥固定漂浮膝关节融合术的 48 例患者。除了进行临床、分析和影像学评估外，还使用新创建的量表对患者进行功能评估。
平均随访 4 年（1 年至 9 年），7 例患者发生再感染（14.6%）。感染复发与性别（P =.16）、年龄（P =.09）或先前接受的手术类型（P =.18）无关，也与 McPherson 宿主分级（P =.4）无关。McPherson 肢体分级为 3 级的患者比 McPherson 肢体分级为 2 级的患者更易发生再感染（P =.034）。26 例患者（54%）接受了膝关节融合功能量表（BAOR）的全面评估和评分。11 例（42%）患者的结果评估为优秀，11 例（42%）为可接受，3 例（12%）为低，1 例（4%）为差。
对于复发性 PJI 患者，融合钉是一种有效且安全的方法，当不符合新翻修全膝关节置换术标准时，是一种有效的替代方法。
