Abstract
Aim: To review our practice of performing two-stage revision for infected total knee arthroplasty by using articulating interval prosthesis and short course parenteral antibiotic therapy
Patients and Methods: We included 70 patients treated by a single surgeon using a uniform protocol since 2001. All patients were planned to have two- stage revision for infected total knee arthroplasty with an articulating interval prosthesis made up of cruciate retaining femur and all poly tibia at stage one. All patients were given short course parenteral antibiotic therapy (5 days IV) followed by and 6 weeks dual oral therapy.
Results: The average age was 68 yrs at the time of first stage. Five patients required repeat of 1st stage procedure because of persistent infection. Twenty six (40%) patients opted not to have a 2nd stage procedure because of eradication of infection after 1st stage and good functional result with interval prosthesis. We had recurrence of infection in 6 patients after two-stage procedure at a mean follow up of 42 months. Four patients out of these six had multiple surgeries for infection before our two-stage protocol
Conclusion: Articulating interval prosthesis gives excellent function and also makes subsequent revision easier with well preserved soft tissue balance. It also takes pressure off on the time constraint for the 2nd stage and good number of them may not require a 2nd stage at all. Our results of recurrence are comparable with published literature evidence and we don’t think that prolonged parenteral antibiotics therapy is required provided adequate surgical debridement has been performed.
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.
