Abstract
Purpose of the study: The purpose of this study is to present our initial experience of single stage revision surgery for infected total knee arthroplasty (TKA).
Methods and results: 12 patients underwent single stage revision for infected TKA. The average patient age was 72.5 years and M: F was 2:1. 5 of the 12 patients had frank infection with presence of discharging sinuses pre-operatively. The procedure involved explantation, debridement, subtotal synovectomy, use of high pressure carbon dioxide (Carbojet) and re-implantation using revision prosthesis and antibiotic laden cement. Utmost care was taken to restore the balance and stability of the revised knee. All the patients were given appropriate intravenous and oral antibiotics in the peri-operative period. Oxford knee scores (OKS) were obtained pre-operatively and at the latest follow-up. Patient satisfaction was also assessed.
At the latest follow-up, none of the patients had recurrence of the infection nor did they need any further surgical procedure. There was no radiographic evidence of loosening of the prosthesis. The OKS had improved from a mean of 17 pre-operative to 41 at the latest follow-up. All the patients were extremely satisfied with the outcome.
Conclusion: Knee function and patient satisfaction improved significantly after single stage revision for infected TKA. None of the patients needed further surgery in the short term. Early results are very encouraging and this change in practice may save on costs and patient morbidity associated with the second stage.
Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
