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Bone & Joint Open
Vol. 2, Issue 5 | Pages 305 - 313
3 May 2021
Razii N Clutton JM Kakar R Morgan-Jones R

Aims

Periprosthetic joint infection (PJI) is a devastating complication following total knee arthroplasty (TKA). Two-stage revision has traditionally been considered the gold standard of treatment for established infection, but increasing evidence is emerging in support of one-stage exchange for selected patients. The objective of this study was to determine the outcomes of single-stage revision TKA for PJI, with mid-term follow-up.

Methods

A total of 84 patients, with a mean age of 68 years (36 to 92), underwent single-stage revision TKA for confirmed PJI at a single institution between 2006 and 2016. In all, 37 patients (44%) were treated for an infected primary TKA, while the majority presented with infected revisions: 31 had undergone one previous revision (36.9%) and 16 had multiple prior revisions (19.1%). Contraindications to single-stage exchange included systemic sepsis, extensive bone or soft-tissue loss, extensor mechanism failure, or if primary wound closure was unlikely to be achievable. Patients were not excluded for culture-negative PJI or the presence of a sinus.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIX | Pages 56 - 56
1 Jul 2012
Azam A Agarwal S Morgan-Jones R
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Purpose of the study

This study was undertaken to evaluate the early results of a new implant system - the metaphyseal sleeve - in revision total knee replacement. The femoral and tibial metaphyseal sleeves are a modular option designed to deal with metaphyseal bone loss and achieve cementless fixation over a relatively wide area in the metaphysis.

Methods

Over three years, femoral and/or tibial metaphyseal sleeves were implanted in 104 knees in 103 patients (54 male and 49 female). The clinical notes and radiographs of these patients were reviewed retrospectively. Thirty one patients had revision for infection, 42 for aseptic loosening, and 31 for instability, pain or stiffness. Eighty nine knees were revised as a single stage and 15 were done as two stage procedure. Minimum follow up is 12 months (average 18.5 months).