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Early results of single stage revision for infected total knee arthroplasty


Presenting Author - Abhijit C Kawalkar
Background Prosthetic joint infection is the one of the most difficult complication of total knee arthroplasty. The incidence of prosthetic joint infection has remained fairly constant over the past few decades, ranging between 0.7% and 2%, but with an increasing number of arthroplasties being performed, the number of infected prosthesis will increase. Currently two stage revision is considered as gold standard treatment for prosthetic knee joint infections. But this exposes patient to the risk of two operations, requires a prolonged hospital stay and a prolonged period of immobilization or limited mobilization of the affected joint and also place an enormous financial burden on the health care sector. Thus single stage revision could be an alternative option if found equally effective. So the purpose of this study is to evaluate the results of single stage revision interns of infection control and functional outcome. Patients and methods We present the results of consecutive series of 12 single-stage revision total knee replacements for established chronic prosthetic knee joint infection performed since 2012. There were 9 males and 2 females with mean age of 68 years. Right knee was affected in 6 patients, left in 4 patients and 1 patient had bilateral involvement. The results were evaluated in terms of infection control, pre and post operative Oxford knee scores and range of motion in operated knee joint. Results All eleven patients were available for follow up; mean duration of follow up being 36 months. Only one patient required revision surgery for recurrent infection, achieving infection control rate of 91.6%. The Oxford knee scores improved significantly from the mean pre operative value of 13 to mean post operative scores of 35; P value < 0.05. Conclusion We conclude that, single stage revision is highly successful and safe in eradicating deep peri-prosthetic knee joint infection in highly complex cohort of patients, traditionally not deemed suitable for a single stage revision.