Two-Stage Revision TKA Is Associated with High Complication and Failure Rates
Identifieur interne : 002365 ( Main/Exploration ); précédent : 002364; suivant : 002366Two-Stage Revision TKA Is Associated with High Complication and Failure Rates
Auteurs : Christopher E. Pelt [États-Unis] ; Ray Grijalva [États-Unis] ; Lucas Anderson [États-Unis] ; Mike B. Anderson [États-Unis] ; Jill Erickson [États-Unis] ; Christopher L. Peters [États-Unis]Source :
- Advances in Orthopedics [ 2090-3464 ] ; 2014.
Abstract
Despite two-stage revision remaining the gold standard in treating periprosthetic infection of total knee arthroplasty (TKA), there remains uncertainty regarding the actual success rate and the risk factors for failure. We retrospectively reviewed 58 knees with mean follow-up of 38 months who underwent two-stage revision TKAs from 1998 to 2012 by a single surgeon. Failure was defined as persistent infection or reoperation after two-stage revision TKA surgery. Failure occurred in 36%. The overall mortality was 22%. The mean time to reinfection was 26 months. Polymicrobial infection was associated with a higher risk of failure (RR 3.31,
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DOI: 10.1155/2014/659047
PubMed: 25610660
PubMed Central: 4290645
Affiliations:
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Pelt</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108</wicri:regionArea><wicri:noRegion>UT 84108</wicri:noRegion></affiliation></author><author><name sortKey="Grijalva, Ray" sort="Grijalva, Ray" uniqKey="Grijalva R" first="Ray" last="Grijalva">Ray Grijalva</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108</wicri:regionArea><wicri:noRegion>UT 84108</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Lucas" sort="Anderson, Lucas" uniqKey="Anderson L" first="Lucas" last="Anderson">Lucas Anderson</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108</wicri:regionArea><wicri:noRegion>UT 84108</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Mike B" sort="Anderson, Mike B" uniqKey="Anderson M" first="Mike B." last="Anderson">Mike B. Anderson</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108</wicri:regionArea><wicri:noRegion>UT 84108</wicri:noRegion></affiliation></author><author><name sortKey="Erickson, Jill" sort="Erickson, Jill" uniqKey="Erickson J" first="Jill" last="Erickson">Jill Erickson</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108</wicri:regionArea><wicri:noRegion>UT 84108</wicri:noRegion></affiliation></author><author><name sortKey="Peters, Christopher L" sort="Peters, Christopher L" uniqKey="Peters C" first="Christopher L." last="Peters">Christopher L. 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Pelt</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108</wicri:regionArea><wicri:noRegion>UT 84108</wicri:noRegion></affiliation></author><author><name sortKey="Grijalva, Ray" sort="Grijalva, Ray" uniqKey="Grijalva R" first="Ray" last="Grijalva">Ray Grijalva</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108</wicri:regionArea><wicri:noRegion>UT 84108</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Lucas" sort="Anderson, Lucas" uniqKey="Anderson L" first="Lucas" last="Anderson">Lucas Anderson</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108</wicri:regionArea><wicri:noRegion>UT 84108</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Mike B" sort="Anderson, Mike B" uniqKey="Anderson M" first="Mike B." last="Anderson">Mike B. Anderson</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108</wicri:regionArea><wicri:noRegion>UT 84108</wicri:noRegion></affiliation></author><author><name sortKey="Erickson, Jill" sort="Erickson, Jill" uniqKey="Erickson J" first="Jill" last="Erickson">Jill Erickson</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108</wicri:regionArea><wicri:noRegion>UT 84108</wicri:noRegion></affiliation></author><author><name sortKey="Peters, Christopher L" sort="Peters, Christopher L" uniqKey="Peters C" first="Christopher L." last="Peters">Christopher L. Peters</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108</wicri:regionArea><wicri:noRegion>UT 84108</wicri:noRegion></affiliation></author></analytic><series><title level="j">Advances in Orthopedics</title><idno type="ISSN">2090-3464</idno><idno type="eISSN">2090-3472</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Despite two-stage revision remaining the gold standard in treating periprosthetic infection of total knee arthroplasty (TKA), there remains uncertainty regarding the actual success rate and the risk factors for failure. We retrospectively reviewed 58 knees with mean follow-up of 38 months who underwent two-stage revision TKAs from 1998 to 2012 by a single surgeon. Failure was defined as persistent infection or reoperation after two-stage revision TKA surgery. Failure occurred in 36%. The overall mortality was 22%. The mean time to reinfection was 26 months. Polymicrobial infection was associated with a higher risk of failure (RR 3.31, <italic>P</italic> < 0.001). Knees requiring soft tissue coverage were also at a greater risk of failure (RR 2.67, <italic>P</italic> = 0.001), as were knees that underwent four or more additional surgeries after the primary TKA and prior to stage-one explantation (RR 2.25, <italic>P</italic> = 0.020). Thus, opportunities exist for improvement in management of infected TKA.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Blom, A W" uniqKey="Blom A">A. W. 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Mason</name></author><author><name sortKey="Odum, S" uniqKey="Odum S">S. Odum</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hofmann, A A" uniqKey="Hofmann A">A. A. Hofmann</name></author><author><name sortKey="Kane, K R" uniqKey="Kane K">K. R. Kane</name></author><author><name sortKey="Tkach, T K" uniqKey="Tkach T">T. K. Tkach</name></author><author><name sortKey="Plaster, R L" uniqKey="Plaster R">R. L. Plaster</name></author><author><name sortKey="Camargo, M P" uniqKey="Camargo M">M. P. Camargo</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>États-Unis</li></country></list><tree><country name="États-Unis"><noRegion><name sortKey="Pelt, Christopher E" sort="Pelt, Christopher E" uniqKey="Pelt C" first="Christopher E." last="Pelt">Christopher E. Pelt</name></noRegion><name sortKey="Anderson, Lucas" sort="Anderson, Lucas" uniqKey="Anderson L" first="Lucas" last="Anderson">Lucas Anderson</name><name sortKey="Anderson, Mike B" sort="Anderson, Mike B" uniqKey="Anderson M" first="Mike B." last="Anderson">Mike B. Anderson</name><name sortKey="Erickson, Jill" sort="Erickson, Jill" uniqKey="Erickson J" first="Jill" last="Erickson">Jill Erickson</name><name sortKey="Grijalva, Ray" sort="Grijalva, Ray" uniqKey="Grijalva R" first="Ray" last="Grijalva">Ray Grijalva</name><name sortKey="Peters, Christopher L" sort="Peters, Christopher L" uniqKey="Peters C" first="Christopher L." last="Peters">Christopher L. Peters</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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