Abstract
Purpose
Two-stage re-implantation after infection of Total Knee Arthroplasty (TKA), remains the gold standard to which other forms of treatment should be compared. The primary purpose of this study was to determine the rates of failure and functional outcome of two stage revision TKA for treatment of infection comparing cemented posterior stabilized compared to constrained condylar implants.
Method
The study group included 25 consecutive patients who had two stage revision TKA to treat infection with an average follow up of 3.25 1.5 years (range 2–6). In all patients the diagnosis of infection was made using standard serum parameters as well as aspiration for joint fluid analysis. Eight patients had posterior stabilized TKAs and 17 patients with had constrained condylar TKAs. Clinical evaluation included the Knee Society Knee Scores (KSKS) at each follow-up visit as well as a detailed record of any difficulties or complications.
Results
No patient (8/8) in the LPS posterior stabilized group and 16 of 17 (94.1%) patients in the LCCK constrained condylar group, had any complaint indicative of instability. Two patients (8%) had re-infection (1 in each group). There was no significant difference between the knee scores (p=0.64) and function scores (p=0.38) of the LPS posterior stabilized and LCCK constrained condylar groups at latest follow up.
Conclusion
Our findings suggest that the strategy of using the least constrained implants that provide adequate stability as judged intra-operatively is appropriate also in 2 stage revision TKAs for infection.
