Long‐term outcome of periprosthetic joint infection following unicompartmental knee arthroplasty: A single‐centre case series
Abstract Purpose Periprosthetic joint infection (PJI) following unicompartmental knee arthroplasty (UKA) is a rare but serious complication. The data available on this topic are heterogeneous and limited, particularly in regard to long‐term survival and patient‐reported outcomes (PROs). Therefore, t...
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| Format: | Article |
| Language: | English |
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Wiley
2025-04-01
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| Series: | Journal of Experimental Orthopaedics |
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| Online Access: | https://doi.org/10.1002/jeo2.70230 |
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| author | Kevin‐Arno Koch Johannes Weishorn Jakob Freytag Pia‐Elena Frey Mustafa Hariri Christian Merle Tilman Walker |
| author_facet | Kevin‐Arno Koch Johannes Weishorn Jakob Freytag Pia‐Elena Frey Mustafa Hariri Christian Merle Tilman Walker |
| author_sort | Kevin‐Arno Koch |
| collection | DOAJ |
| description | Abstract Purpose Periprosthetic joint infection (PJI) following unicompartmental knee arthroplasty (UKA) is a rare but serious complication. The data available on this topic are heterogeneous and limited, particularly in regard to long‐term survival and patient‐reported outcomes (PROs). Therefore, the aim of the present study was to analyse the long‐term survival and functional outcome of a case series of PJI following primary UKA at a tertiary referral centre. Methods Eighteen knees treated for acute or chronic PJI after primary UKA between 2001 and 2020 with a minimum follow‐up of 2 years were retrospectively identified and evaluated in the present study. Surgical treatment included debridement, antibiotics and implant retention (DAIR) in 10 patients, and two‐stage arthroplasty in 8 patients. Implant survival analysis was conducted using the Kaplan–Meier estimator. Patient‐reported outcome measures (PROMs) were used to assess clinical outcomes. Results Overall implant survival free from any revision at 10 years was 83% (95% confidence interval [CI]: 57%–94%). Three DAIR procedures failed due to persistent infection with partially major complications, resulting in a 10‐year revision‐free implant survival of 73% (95% CI: 37%–90%). No reoperation was required in the group that underwent staged treatment. There were no long‐term revisions due to aseptic loosening or degeneration of other compartments in either group. Both groups demonstrated promising median Oxford Knee Scores, with no significant difference (>0.05) between the DAIR (42, range 11–45) and two‐stage exchange arthroplasty (43, range 19–46) groups. Conclusions Two‐stage revision procedure offers excellent long‐term survival and high patient satisfaction. The DAIR procedure represents a valid treatment option for acute PJI but carries a certain risk of treatment failure that surgeons should be aware of. Successful treatment of PJI in UKA can provide excellent functional outcomes and long‐term survival without an increased risk of low‐grade infection and aseptic loosening. Level of Evidence Level IV. |
| format | Article |
| id | doaj-art-e9435ca0d76544cfa9692bb6182bf84c |
| institution | Kabale University |
| issn | 2197-1153 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj-art-e9435ca0d76544cfa9692bb6182bf84c2025-08-20T04:03:13ZengWileyJournal of Experimental Orthopaedics2197-11532025-04-01122n/an/a10.1002/jeo2.70230Long‐term outcome of periprosthetic joint infection following unicompartmental knee arthroplasty: A single‐centre case seriesKevin‐Arno Koch0Johannes Weishorn1Jakob Freytag2Pia‐Elena Frey3Mustafa Hariri4Christian Merle5Tilman Walker6Department of Orthopaedic Surgery University Hospital of Heidelberg Heidelberg GermanyDepartment of Orthopaedic Surgery University Hospital of Heidelberg Heidelberg GermanyDepartment of Orthopaedic Surgery University Hospital of Heidelberg Heidelberg GermanyDepartment of Orthopaedic Surgery University Hospital of Heidelberg Heidelberg GermanyDepartment of Orthopaedic Surgery University Hospital of Heidelberg Heidelberg GermanyOrthopaedic Centre Paulinenhilfe, Diakonie‐Klinikum Stuttgart Stuttgart GermanyDepartment of Orthopaedic Surgery University Hospital of Heidelberg Heidelberg GermanyAbstract Purpose Periprosthetic joint infection (PJI) following unicompartmental knee arthroplasty (UKA) is a rare but serious complication. The data available on this topic are heterogeneous and limited, particularly in regard to long‐term survival and patient‐reported outcomes (PROs). Therefore, the aim of the present study was to analyse the long‐term survival and functional outcome of a case series of PJI following primary UKA at a tertiary referral centre. Methods Eighteen knees treated for acute or chronic PJI after primary UKA between 2001 and 2020 with a minimum follow‐up of 2 years were retrospectively identified and evaluated in the present study. Surgical treatment included debridement, antibiotics and implant retention (DAIR) in 10 patients, and two‐stage arthroplasty in 8 patients. Implant survival analysis was conducted using the Kaplan–Meier estimator. Patient‐reported outcome measures (PROMs) were used to assess clinical outcomes. Results Overall implant survival free from any revision at 10 years was 83% (95% confidence interval [CI]: 57%–94%). Three DAIR procedures failed due to persistent infection with partially major complications, resulting in a 10‐year revision‐free implant survival of 73% (95% CI: 37%–90%). No reoperation was required in the group that underwent staged treatment. There were no long‐term revisions due to aseptic loosening or degeneration of other compartments in either group. Both groups demonstrated promising median Oxford Knee Scores, with no significant difference (>0.05) between the DAIR (42, range 11–45) and two‐stage exchange arthroplasty (43, range 19–46) groups. Conclusions Two‐stage revision procedure offers excellent long‐term survival and high patient satisfaction. The DAIR procedure represents a valid treatment option for acute PJI but carries a certain risk of treatment failure that surgeons should be aware of. Successful treatment of PJI in UKA can provide excellent functional outcomes and long‐term survival without an increased risk of low‐grade infection and aseptic loosening. Level of Evidence Level IV.https://doi.org/10.1002/jeo2.70230DAIRlong‐term outcomeperiprosthetic joint infectionrevision surgerytwo‐stage exchange arthroplastyunicompartmental knee arthroplasty |
| spellingShingle | Kevin‐Arno Koch Johannes Weishorn Jakob Freytag Pia‐Elena Frey Mustafa Hariri Christian Merle Tilman Walker Long‐term outcome of periprosthetic joint infection following unicompartmental knee arthroplasty: A single‐centre case series Journal of Experimental Orthopaedics DAIR long‐term outcome periprosthetic joint infection revision surgery two‐stage exchange arthroplasty unicompartmental knee arthroplasty |
| title | Long‐term outcome of periprosthetic joint infection following unicompartmental knee arthroplasty: A single‐centre case series |
| title_full | Long‐term outcome of periprosthetic joint infection following unicompartmental knee arthroplasty: A single‐centre case series |
| title_fullStr | Long‐term outcome of periprosthetic joint infection following unicompartmental knee arthroplasty: A single‐centre case series |
| title_full_unstemmed | Long‐term outcome of periprosthetic joint infection following unicompartmental knee arthroplasty: A single‐centre case series |
| title_short | Long‐term outcome of periprosthetic joint infection following unicompartmental knee arthroplasty: A single‐centre case series |
| title_sort | long term outcome of periprosthetic joint infection following unicompartmental knee arthroplasty a single centre case series |
| topic | DAIR long‐term outcome periprosthetic joint infection revision surgery two‐stage exchange arthroplasty unicompartmental knee arthroplasty |
| url | https://doi.org/10.1002/jeo2.70230 |
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