Abstract
To review the outcome of patients with deep infection using a new 2-stage revision technique.
A management plan consisting of initial debridement, insertion of antibiotic spacers and 2 weeks of intravenous antibiotics is currently used. No further antibiotics are given systemically. If blood tests are satisfactory at 12 weeks, reimplantation occurs. Patients are encouraged to partially weight-bear and perform a range of motion exercises with their spacers in place. The necessary data has been prospectively collected to identify predictors of success.
Thirty four patients have been identified and fully followed up for more than 1 year. 27 patients have over 2 years of follow-up. When looking at all of the patients we have achieved an 82% success rate. For patients whose only previous major surgery was their arthroplasty this rises to 90%. Where multiple surgeries have been undertaken this falls to 73%. All of the peri-operative investigations have been reviewed and whilst they have a good negative predictive value they are not specific enough to alter practice.
Conclusions: Short courses of parenteral treatment can produce comparable results to previously- published series when treating deep infection after knee replacement. There seems to be a failure rate that is difficult to avoid associated with chronic, multiple revision cases.
The abstracts were prepared by Mr Tim Briggs. (Editoral Secretary 2003/4) Correspondence should be addressed to him at Lane Farm, Chapel Lane, Totternhoe, Dunstable, Bedfordshire LU6 2BZ, United Kingdom
