The parameters affecting the success of irrigation and debridement with component retention in the treatment of acutely infected total knee arthroplasty

Citations

SCOPUS

34

초록

Background: The aims of our study were to evaluate the success rate of irrigation and debridement with component retention (IDCR) for acutely infected total knee arthroplasty (TKA) (< 4 weeks of symptom duration) and to analyze the factors affecting prognosis of IDCR.Methods: We retrospectively reviewed 28 knees treated by IDCR for acutely infected TKA from 2003 to 2012. We evaluated the success rate of IDCR. All variables were compared between the success and failure groups. Multivariable logistic regression analysis was also used to examine the relative contribution of these parameters to the success of IDCR.Results: Seventeen knees (60.7%) were successfully treated. Between the success and failure groups, there were significant differences in the time from primary TKA to IDCR (p = 0.021), the preoperative erythrocyte sedimentation rate (ESR; p = 0.021), microorganism (p = 0.006), and polyethylene liner exchange (p = 0.017). Multivariable logistic regression analysis of parameters affecting the success of IDCR demonstrated that preoperative ESR (odds ratio [OR], 1.02; p = 0.041), microorganism (OR, 12.4; p = 0.006), and polyethylene liner exchange (OR, 0.07; p = 0.021) were significant parameters.Conclusions: The results show that 60.7% of the cases were successfully treated by IDCR for acutely infected TKA. The preoperative ESR, microorganism, and polyethylene liner exchange were factors that affected the success of IDCR in acutely infected TKA. © 2015 by The Korean Orthopaedic Association.

키워드

Arthroplasty; Debridement; Knee; cefazolin; cephalosporin derivative; ciprofloxacin; levofloxacin; meropenem; polyethylene; rifampicin; vancomycin; antiinfective agent; adult; aged; antibiotic sensitivity; arthroscopic surgery; Article; bacterium culture; Charlson Comorbidity Index; clinical article; controlled study; debridement with component retention; disease duration; erythrocyte sedimentation rate; female; human; infection control; knee osteoarthritis; lavage; male; medical record review; methicillin resistant Staphylococcus aureus; methicillin susceptible Staphylococcus aureus; methicillin susceptible Staphylococcus epidermidis; methicillin-resistant Staphylococcus epidermidis; neuropathic joint disease; nonhuman; outcome assessment; postoperative infection; preoperative evaluation; prognosis; reoperation; retrospective study; rheumatoid arthritis; Staphylococcus epidermidis; surgical technique; synovectomy; total knee replacement; treatment failure; adverse effects; arthroscopy; debridement; Joint Diseases; knee; knee arthroplasty; knee prosthesis; lavage; microbiology; middle aged; Prosthesis-Related Infections; treatment outcome; very elderly; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Arthroplasty, Replacement, Knee; Arthroscopy; Debridement; Female; Humans; Joint Diseases; Knee Joint; Knee Prosthesis; Male; Middle Aged; Prosthesis-Related Infections; Retrospective Studies; Therapeutic Irrigation; Treatment Outcome
제목
The parameters affecting the success of irrigation and debridement with component retention in the treatment of acutely infected total knee arthroplasty
저자
Kim J.G.; Bae J.H.; Lee S.Y.; Cho W.T.; Lim H.C.
DOI
10.4055/cios.2015.7.1.69
발행일
2015
유형
Article
저널명
Clinics in Orthopedic Surgery
권
7
호
1
페이지
69 ~ 76