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Risk factors for early septic failure after two-stage exchange total knee arthroplasty for treatment of periprosthetic joint infection

Authors
 Woo-Suk Lee  ;  Kwan Kyu Park  ;  Byung-Woo Cho  ;  Jun Young Park  ;  Inuk Kim  ;  Hyuck Min Kwon 
Citation
 JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY, Vol.25(1) : 6, 2024-02 
Journal Title
JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY
ISSN
 1590-9921 
Issue Date
2024-02
MeSH
Adult ; Anti-Bacterial Agents / therapeutic use ; Arthroplasty, Replacement, Knee* / adverse effects ; Humans ; Knee Joint / surgery ; Knee Prosthesis* / adverse effects ; Male ; Prosthesis-Related Infections* / diagnosis ; Prosthesis-Related Infections* / etiology ; Prosthesis-Related Infections* / surgery ; Reoperation ; Retrospective Studies ; Risk Factors
Keywords
Periprosthetic joint infection ; Reimplantation ; Septic failure ; Two-stage exchange total knee arthroplasty
Abstract
BackgroundThe cause of early septic failure after two-stage exchange revision total knee arthroplasty (TKA) for chronic periprosthetic joint infection (PJI) and the factors affecting it are not well known. The purpose of this study was to determine the surgical outcomes and the risk factors for early septic failure after two-stage revision TKA for chronic PJI.MethodsWe identified a total of 246 adult patients who met the Musculoskeletal Infection Society (MSIS) diagnostic criteria for chronic PJI at two academic tertiary hospitals from March 2012 to December 2018. Finally, 151 patients who consecutively received two-stage exchange revision TKA for chronic PJI and who had a minimum 3-year follow-up were enrolled and retrospectively reviewed. Successful surgical treatment was evaluated for two-stage revision TKA and risk factors for early septic failure were identified.ResultsEarly septic failures occurred within 3 years after reimplantation in 48 patients (31.8%). After accounting for potentially confounding variables, we found that male patient [odds ratio (OR): 2.753, 95% confidence interval (CI) 1.099-6.893, p = 0.031], fungus or mycobacterial infection (OR: 5.224, 95% CI 1.481-18.433, p = 0.01), and positive culture at reimplantation (OR: 4.407, 95% CI 1.255-15.480, p = 0.021) were independently associated with early septic failure after two-stage exchange revision TKA.ConclusionMale patients, fungus or mycobacterial infection, and positive culture at reimplantation were independently associated with an increased risk of early septic failure after two-stage exchange revision TKA despite normal C-reactive protein values prior to reimplantation. Further prospective and high-quality studies are needed to determine the risk factors of two-stage exchange revision TKA for chronic PJI.Level of evidence: level IV; retrospective comparison; treatment study.ConclusionMale patients, fungus or mycobacterial infection, and positive culture at reimplantation were independently associated with an increased risk of early septic failure after two-stage exchange revision TKA despite normal C-reactive protein values prior to reimplantation. Further prospective and high-quality studies are needed to determine the risk factors of two-stage exchange revision TKA for chronic PJI.Level of evidence: level IV; retrospective comparison; treatment study.
Files in This Item:
T202401732.pdf Download
DOI
10.1186/s10195-024-00750-w
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Hyuck Min(권혁민) ORCID logo https://orcid.org/0000-0002-2924-280X
Park, Kwan Kyu(박관규) ORCID logo https://orcid.org/0000-0003-0514-3257
Park, Jun Young(박준영) ORCID logo https://orcid.org/0000-0002-4713-4036
Lee, Woo Suk(이우석) ORCID logo https://orcid.org/0000-0002-0798-1660
Cho, Byung Woo(조병우) ORCID logo https://orcid.org/0000-0002-7472-4103
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198818
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