Document Detail

Assessing the gold standard: a review of 253 two-stage revisions for infected TKA.
MedLine Citation:
PMID:  22538959     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Periprosthetic joint infection has been the leading cause of failure following TKA surgery. The gold standard for infection control has been a two-staged revision TKA. There have been few reports on mid- to long-term survivorship, functional outcomes, and fate of patients with a failed two-stage revision TKA.
QUESTIONS/PURPOSES: Therefore, we determined (1) the mid-term survivorship of two-stage revision TKA, (2) the function of patients in whom infection was controlled, and (3) the outcome of patients with a failed two-stage revision due to recurrent infection.
METHODS: We retrospectively reviewed 239 patients who underwent 253 two-stage revision TKAs for periprosthetic infection. There were 239 patients (253 knees), 104 men and 135 women, with a mean age of 70 ± 10 years at the time of two-stage revision and a mean BMI of 31.53 ± 6.74 kg/m2. During followup, we obtained WOMAC and The Knee Society Clinical Rating Scores and radiographs. The minimum followup was 1 year (median, 4 years; range, 1-17 years).
RESULTS: Thirty-three patients experienced a failed two-staged TKA. Sixteen patients experienced failure due to recurrent sepsis. There were 17 failures for aseptic causes.
CONCLUSION: The overall infection-free survivorship for two-stage revision TKA was 85% at 5 years and 78% at 10 years.
LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Tahir Mahmud; Matthew C Lyons; Douglas D Naudie; Steven J Macdonald; Richard W McCalden
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  470     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-14     Completed Date:  2012-11-19     Revised Date:  2013-10-13    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2730-6     Citation Subset:  AIM; IM    
Division of Orthopaedic Surgery, University of Western Ontario & London Health Sciences Centre, University Campus, 339 Windermere Road, London, ON, N6A 5A5, Canada.
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MeSH Terms
Arthroplasty, Replacement, Knee / methods*
Disease-Free Survival
Knee Prosthesis / adverse effects*
Prosthesis-Related Infections / surgery*
Reoperation / methods
Retrospective Studies

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