Background: Short-term cure rates of two stage revision for infection after TKR are approximately 90%. Little is known about the long-term reinfection-free survival or the mechanical durability of the reimplanted prostheses. The purpose of the study is to evaluate the mid to long term results of this technique with regards to persistence of infection, clinical and radiographic results. The hypothesis is that the success rate of the technique is maintained through long term follow-up, with a low rate of recurrent infection and mechanical implant failure.

Methods: from January 1990 to august 2002, 124 two stage revision TKR for infection were performed at Our Institution with mean follow-up of 9,8 years (5 to 17,5).

The clinical results were evaluated with SF12, WOMAC, and KSCRS performed preoperatively and postoperatively at 5 and 10 years. A radiographic analysis was performed using x-rays of the last available follow-up.

Results: the WOMAC and KSCRS significantly improved at the 5 years follow-up decreasing slightly at 10 years. The SF12 postoperative variation was not significant. The radiographic results showed possible loosening of the tibial or femoral components on 17% and 12% of patients respectively. There were 17 reoperations, 10 of which for persistent infection (85% of survival at 10 years).

Discusssion and conclusion: we are encouraged by the rate of eradication of infection at 10 or more years in these difficult cases. The long term clinical and radiographic results are satisfactory. The study supports the sustained use of this technique for infected total knee arthroplasties.