Skip to main content
Online ISSN: 2723-7826 | Print ISSN: 2723-7818
Research Articles

Treatment of Chronic Prosthetic Joint Infection after Total Knee Arthroplasty with Two-stage Revision

DOI: https://doi.org/10.46355/hipknee.v5i1.135

Abstract

Periprosthetic joint infection (PJI) is common among complications of knee arthroplasty. Treatment is based on many factors in each patient individually, especially the time onset of infection whether it is acute or chronic. Two stage revision is the best method in chronic PJI case under certain circumstances. There are few patients in three years period whom diagnosed with chronic PJI after Total Knee Arthroplasty (TKA). All patients diagnosed more than three months postoperatively, confirmed by clinically sinuses on the knee, and some patients have blood test and radiological sign of infection. All treated with two stage revision which is debridement, removal all implant & put articulating knee spacer in the first operation, continue with arthroplasty with constrain implant in the second operation after infection confirmly eradicated and treated by one consultant surgeon in the same hospital. All patients treated with the same method have good results which are no pain, stable knee and satisfying knee Range of motion (ROM) following different recovery time. Two-stage revision have a good success rate in chronic PJI treatment as long as the patient fulfill the treatment criteria.

References

  1. Tande A J, Patel R. Prosthetic Joint Infection. Clinical Microbiology Reviews, p 302-345. April 2014 vol 27.
  2. Trampuz A, Zimmerli W. Prosthetic joint infetion : update in diagnosis and treatment. Swiss Med Wkly. 2005;135:243-251
  3. Pellegrini A, Suardi V, Legnani C. Classification and management options for prosthetic joint infection. Annal of joint. 2022;7:3
  4. Zahar A, Sarungi M. Diagnosis and management of infected total knee replacement: a practical surgical guide.J EXP ORTOP. 2021(8:14)
  5. Middleton R, Avlan A, T Khan. Update of diagnosis and management of prosthetic joint infection in hip and knee arthroplasty. Bone and Joint 360. 2019; 8:4
  6. Franceschini M, Pedreti L, Cerbone V. Two stage revision: indication, technique and results. Annal of joint. 2022;7:4
  7. Junren L, Han J, Zhang C. Infection after total knee arthroplasty and its gold standard surgical treatment: Spacer used in two-stage revision arthroplasty. Intractable & rare disease research. 2017; 6(4) : 256-261
  8. Parvizi J, Philips JRA. Investigation and management of prosthetic joint infection in knee replacement. 2020. British orthopaedic association
  9. Larsen ML, Odgaard A, Fredborg C. One-stage versus two-stage revision of the infected knee arthroplasty. BMC muskuloskeletal disorder. 2021; 22:175
  10. Pina M, Gaukhman A D, Hayden B. Three concurrent periprosthetic joint infections : a case report and literature review. 2019. Hip Pelvis 31(1) : 57-62
  11. Douglas R. Osmon, Elie F. Berbari, et all. Diagnosis & Management of PJI : Clinical Practice Guidelines by the Infectious Disease Society of America. Clinicacal Infectious Disease 2013;56(1):e1-25
  12. Bonanzinga T, Tanzi P, Iacono F, et all. Periprosthetic knee infection : two stage surgery. Acta Biomed 2017; vol. 88, Supplement 4: 114-119
  13. Bejon P, Berendt A, Atkins B L, et all. Two stage revision for prosthetic joint infection : predictors of outcome & the role of reimplantation microbiology. J Antimicrob Chemother 2010; 65: 569-575
  14. Charette R S, Melnic C M. Two stage revision arthroplasty for the treatment of prosthetic joint infection. 2018. Current reviews in musculoskeletal medicine, Springer.