Fungal periprosthetic joint infections (PJIs) are rare, but their diagnosis and treatment are highly challenging. The purpose of this study was to investigate the clinical outcomes of patients with fungal PJIs treated with two-stage exchange knee arthroplasty combined with prolonged antifungal therapy. We reviewed our institutional joint arthroplasty database and identified 41 patients diagnosed with fungal PJIs and treated with two-stage exchange arthroplasty after primary total knee arthroplasty (TKA) between January 2001 and December 2020, and compared them with those who had non-fungal PJIs during the same period. After propensity score matching based on age, sex, BMI, American Society of Anesthesiologists grade, and Charlson Comorbidity Index, 40 patients in each group were successfully matched. The surgical and antimicrobial treatment, patient demographic and clinical characteristics, recurrent infections, survival rates, and relevant risk factors that affected joint survivorship were analyzed. We defined treatment success as a well-functioning arthroplasty without any signs of a PJI, and without antimicrobial suppression, at a minimum follow-up of two years from the time of reimplantation.Aims
Methods
Septic knee arthritis with severe osteoarthritis (OA) presents challenging clinical situations because of unexpected and long time for treatment and less satisfactory clinical outcomes. Septic arthritis with damage to articular cartilage developed osteomyelitis (OM) frequently. Although arthroscopic debridement was the common treatment of septic arthritis, there was some limitation on the management of infected bone structures and then open arthrotomy should be reserved. In the patients of OM located only periarticular areas, the author used the PROSTALAC system for infected total knee arthroplasty (TKA) and achieved good results. In periarticular OM with septic knee arthritis in patients with severe OA, we report the rate of control of infection using the PROSTALAC articulating spacer and to assess the clinical outcome after staged TKA.Introduction
Objectives
