Infected total knee arthroplasty treatment outcome analysis
Background/Aim. Infected total knee arthroplasty (TKA) is a topic of great importance, because its diagnosing and treatment requires a lot of resources, and often has an unsatisfactory outcome. The aim of this study was to analyze the outcome of the treatment of infection developed following TKA....
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2012-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2012/0042-84501206504R.pdf |
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| author | Radoičić Dragan Popović Zoran Barjaktarović Radoslav Marinković Jugoslav |
| author_facet | Radoičić Dragan Popović Zoran Barjaktarović Radoslav Marinković Jugoslav |
| author_sort | Radoičić Dragan |
| collection | DOAJ |
| description | Background/Aim. Infected total knee arthroplasty (TKA) is a topic of great importance, because its diagnosing and treatment requires a lot of resources, and often has an unsatisfactory outcome. The aim of this study was to analyze the outcome of the treatment of infection developed following TKA. Methods. This retrospective study of infected TKAs was performed in the period from 1998 to 2008 in the Orthopedics & Traumatology Clinic of the Military Medical Academy (MMA) in Belgrade. A total of 654 primary and revised TKAs were performed in the said period. We registered and surgically treated 28 infected TKAs (primary TKAs: MMA - 22, other institutions - 6). The incidence of TKA infection in the MMA was 3.36%. The most common pathogens were: Staphylococcus aureus - 14 (50%) cases, and Staph. epidermidis - 3 (10.7%) cases. Other isolated pathogens were: Enterococcus faecalis, Klebsiella pneum., Klebsiella spp., Streptoccocus viridans, Seratia spp, Micrococcus luteus and Peptostreptococcus spp. In one case we had mixed anaerobic flora, and in 3 cases cultures were negative. We analyzed diagnostic challenges, risk factors (such as age and previous viscosupplementation) and treatment outcomes in our series of infected TKAs. Results. In our series 2 infections healed after iv antibiotics and debridement, 1 patient responded to open debridement with component retention, 4 patients responded fully to one-stage reimplantation, 10 cases responded fully to two-stage reimplantation, 11 patients ended with arthrodesis and we had 1 patient with above knee amputation. Conclusion. Two-stage reimplantation remains gold standard for treatment of infected TKA, and we recommend it as treatment of choice for eradication of infection. The antibiotic loaded spacer prothesis concept in most cases allows infection eradication, good function and high patient satisfaction. |
| format | Article |
| id | doaj-art-ff6a33a3810f49a381f9799643cf7aae |
| institution | DOAJ |
| issn | 0042-8450 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-ff6a33a3810f49a381f9799643cf7aae2025-08-20T03:06:13ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502012-01-0169650450910.2298/VSP1206504RInfected total knee arthroplasty treatment outcome analysisRadoičić DraganPopović ZoranBarjaktarović RadoslavMarinković JugoslavBackground/Aim. Infected total knee arthroplasty (TKA) is a topic of great importance, because its diagnosing and treatment requires a lot of resources, and often has an unsatisfactory outcome. The aim of this study was to analyze the outcome of the treatment of infection developed following TKA. Methods. This retrospective study of infected TKAs was performed in the period from 1998 to 2008 in the Orthopedics & Traumatology Clinic of the Military Medical Academy (MMA) in Belgrade. A total of 654 primary and revised TKAs were performed in the said period. We registered and surgically treated 28 infected TKAs (primary TKAs: MMA - 22, other institutions - 6). The incidence of TKA infection in the MMA was 3.36%. The most common pathogens were: Staphylococcus aureus - 14 (50%) cases, and Staph. epidermidis - 3 (10.7%) cases. Other isolated pathogens were: Enterococcus faecalis, Klebsiella pneum., Klebsiella spp., Streptoccocus viridans, Seratia spp, Micrococcus luteus and Peptostreptococcus spp. In one case we had mixed anaerobic flora, and in 3 cases cultures were negative. We analyzed diagnostic challenges, risk factors (such as age and previous viscosupplementation) and treatment outcomes in our series of infected TKAs. Results. In our series 2 infections healed after iv antibiotics and debridement, 1 patient responded to open debridement with component retention, 4 patients responded fully to one-stage reimplantation, 10 cases responded fully to two-stage reimplantation, 11 patients ended with arthrodesis and we had 1 patient with above knee amputation. Conclusion. Two-stage reimplantation remains gold standard for treatment of infected TKA, and we recommend it as treatment of choice for eradication of infection. The antibiotic loaded spacer prothesis concept in most cases allows infection eradication, good function and high patient satisfaction.http://www.doiserbia.nb.rs/img/doi/0042-8450/2012/0042-84501206504R.pdfarthroplasty, replacement, kneebacterial infectionsdiagnosisdrug therapyanti-bacterial agentsorthopedic procedurestreatment outcome |
| spellingShingle | Radoičić Dragan Popović Zoran Barjaktarović Radoslav Marinković Jugoslav Infected total knee arthroplasty treatment outcome analysis Vojnosanitetski Pregled arthroplasty, replacement, knee bacterial infections diagnosis drug therapy anti-bacterial agents orthopedic procedures treatment outcome |
| title | Infected total knee arthroplasty treatment outcome analysis |
| title_full | Infected total knee arthroplasty treatment outcome analysis |
| title_fullStr | Infected total knee arthroplasty treatment outcome analysis |
| title_full_unstemmed | Infected total knee arthroplasty treatment outcome analysis |
| title_short | Infected total knee arthroplasty treatment outcome analysis |
| title_sort | infected total knee arthroplasty treatment outcome analysis |
| topic | arthroplasty, replacement, knee bacterial infections diagnosis drug therapy anti-bacterial agents orthopedic procedures treatment outcome |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2012/0042-84501206504R.pdf |
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