The Chitranjan Ranawat Award: Fate of Two-stage Reimplantation After Failed Irrigation and Débridement for Periprosthetic Knee Infection

• DOI: 10.1007/s11999-010-1434-1
• Publication Date: 2010-06-25T16:33:15Z
• Authors: Christopher J. Sh...; Thomas K. Fehring; Susan Odum; Erik Hansen; Benjamin Zmistowski; Anne Dennos; Niraj Kalore
• Keywords: Adult; Aged, 80 and over; Male; Reoperation; Chi-Square Distribution; Prosthesis-Related Infections; Time Factors; Knee Joint; Awards and Prizes; Middle Aged; Risk Assessment; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Debridement; Risk Factors; Humans; Female; Arthroplasty, Replacement, Knee; Knee Prosthesis; Therapeutic Irrigation; Aged; Retrospective Studies

Irrigation and débridement is an attractive low morbidity solution for acute periprosthetic knee infection. However, the failure rate in literature high, averaging 68% (range, 61%-82%). Patients who fail subsequently undergo two-stage reimplantation after a prolonged period of illness. This leads to higher surgical risk further delays rehabilitation may contribute subsequent revision surgery.We determined rerevision due infection performed failed irrigation infected TKA.We multicenter retrospective review infections treated with procedure from 1994 2008. Selection criteria study included initial treatment surgery. Failure was defined as need any additional surgery infection.Of 83 knees that had undergone previous débridement, 28 (34%) required reoperation persistent infection.The this series revisions patients considerably than previously reported rates revision. Factors affecting include host quality, thoroughness organism virulence. surgeons must understand while initially attractive, lead high reimplantation.Level III, therapeutic study. See guidelines online complete description level evidence.