Two-stage Total Knee Arthroplasty for Treatment of Surgical Failure of Septic Arthritis in Degenerative Knee Joints | ||
The Archives of Bone and Joint Surgery | ||
مقاله 8، دوره 8، شماره 4، مهر 2020، صفحه 524-530 اصل مقاله (1.12 M) | ||
نوع مقاله: RESEARCH PAPER | ||
شناسه دیجیتال (DOI): 10.22038/abjs.2020.43184.2178 | ||
نویسندگان | ||
Mohammad Naghi Tahmasebi1؛ Arash Sharafat Vaziri1؛ Seyed Hossein Miresmaeili1؛ Mohammad Reza Bozorgmanesh1؛ Shahin Mirkarimi1؛ Mohammad Javad Zehtab1؛ Mohammad Tahami* 2 | ||
1Department of Orthopedics, Tehran University of Medical Sciences, Tehran ,Iran | ||
2Department of orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Bone and Joint Research Center, Shiraz University of Medical Sciences, Shiraz, Iran | ||
چکیده | ||
Background: The ultimate goal of the treatment of infectious knee arthritis is to protect the articular cartilage from adverse effects of infection. Treatment, however, is not always hundred percent successful and has a 12% failure rate. Persistent infection is more likely to happen in elderly patients and those with underlying joint diseases, particularly osteoarthritis. Eradication of infection and restoration of function in the involved joint usually are not possible by conventional treatment strategies. There are few case series reporting two-stage primary knee arthroplasty as the salvage treatment of the septic degenerative knee joint; however, the treatment protocol remains to be elucidated. Methods: Based on a proposed approach, patients with failure of common interventions for treatment of septic knee arthritis and underlying joint degeneration were treated by two-stage TKA and intervening antibiotic loaded static cement spacer. Suppressive antibiotic therapy was not prescribed after the second stage. Results: Complete infection eradication was achieved with mean follow up of 26 months. All cases were balanced with primary total knee prosthesis. The knee scores and final range of motions were comparable to other studies. Conclusion: The two-stage total knee replacement technique is a good option for management of failure of previous surgical treatment in patients with septic arthritis and concomitant joint degeneration. Our proposed approach enabled us to use primary prosthesis in all of our patients with no need for suppressive antibiotic therapy. Level of evidence: IV | ||
کلیدواژهها | ||
Degenerative joint؛ Septic knee arthritis؛ Total knee replacement؛ Two stage arthroplasty | ||
مراجع | ||
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