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Irrigation and Debridement for Early Periprosthetic Knee Infection: Is It Effective?
- Source :
- The Journal of Arthroplasty. 33:1872-1878
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Background Irrigation and debridement (I&D) is performed for early management of periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). Symptom reporting is a subjective measure and may miss direct management of PJI. Utilizing an objective time interval from index procedure to I&D may better inform treatment decisions. Methods From 2009 to 2017, retrospective review was performed of 55 knee PJI cases at our institution. All patients underwent polyethylene liner exchange and I&D for PJI. Patients were stratified by time from index procedure to I&D (≤2 weeks, >2 weeks). Success was defined as eradication of infection and resolution of presenting symptoms. Failed cases required subsequent procedures due to infection. Results Average follow-up time after index TKA was 2.5 years. Among patients with I&D within 2 weeks of index TXA, 14 patients (82%) were successfully treated while 3 (18%) had infection recurrence. These outcomes were significantly improved compared to patients with I&D after 2 weeks: 19 (50%) successes and 19 (50%) failures (P = .024). Staphylococcal species were the most frequent pathogen in patients treated before and after 2 weeks of index TKA (39% and 50%, respectively). Outcomes were pathogen-independent in PJIs treated before or after 2 weeks of index TKA (P = .206 and .594, respectively). Conclusion Our results demonstrate that patients with early PJI managed with I&D and liner exchange within 2 weeks of index TKA had higher rates of treatment success when compared to those with I&D beyond 2 weeks. These findings suggest that time from index TKA to I&D is an objective and reliable indicator of treatment success when considering I&D in acute onset knee PJI.
- Subjects :
- Male
musculoskeletal diseases
medicine.medical_specialty
Prosthesis-Related Infections
Knee Joint
medicine.medical_treatment
Total knee arthroplasty
Periprosthetic
Therapeutic irrigation
03 medical and health sciences
0302 clinical medicine
Synovial Fluid
medicine
Humans
Orthopedics and Sports Medicine
030212 general & internal medicine
Prosthesis-Related Infection
Arthroplasty, Replacement, Knee
Therapeutic Irrigation
Aged
Retrospective Studies
Arthritis, Infectious
030222 orthopedics
Debridement
business.industry
Retrospective cohort study
Middle Aged
Surgery
Orthopedics
Treatment Outcome
Polyethylene
Orthopedic surgery
Female
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 08835403
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- The Journal of Arthroplasty
- Accession number :
- edsair.doi.dedup.....de3e38d5423329eabd01d451a94a86c2