Abstract
Introduction: The purpose of this study was to evaluate the result of treatment of the infected total knee arthroplasty by two-stage revision using antibiotics-impregnated cement spacer and beads.
Materials and methods: Out of 56 total knee arthroplasty revisions, 26 revisions were performed for infected total knee arthroplasties between 1985 and 1996. Two cases of infected total knee arthroplasties were treated by immediate replacement and four cases by arthrodesis. Twenty infected total knee arthroplasties had been revised by two-stage revision and followed-up for 38.6 months in average (range, 18–105 months). They were nine male and eleven female patients of 61.6 years old in average. The primary cause of arthroplasty was osteoarthritis in all. Infection was diagnosed by physical finding, radiography, preoperative aspiration, culture of the pus from draining sinus and culture of surgical specimen. Twelve cases revealed positive growth of causative bacteria, while eight were not identified. The protocol for two-stage revision began with the removal of infected implants and cement. The surrounding bony and soft tissue were thoroughly debrided and cleaned. The dead space between femur and t
Results: Two-stage revision was successful in nineteen cases. One case revealed the recurrence of infection eleven months after reimplantation and underwent the repetition of the same two-stage procedure. At the final follow-up, the average Hospital for Special Surgery score was 81.1 points, the average Knee Society knee score was 78.6 points and the average function score was 76.7 points. Patients could regain average 105 degrees of knee flexion.
Conclusion: The result of two-stage revision for infected total knee arthroplasty is satisfactory, showing that this can be the method of choice for infection treatment and functional restoration. This procedure using antibiotics-impregnated cement spacer and beads can control infection and improve functional results.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
