These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Factors affecting failure of irrigation and debridement with liner exchange in total knee arthroplasty infection.
    Author: Bene N, Li X, Nandi S.
    Journal: Knee; 2018 Oct; 25(5):932-938. PubMed ID: 30111501.
    Abstract:
    BACKGROUND: We sought to determine if reoperation-free survival following irrigation and debridement with polyethylene liner exchange of acutely infected primary TKA is affected by: 1) postoperative antibiotic duration; 2) patient characteristics or surgical factors; 3) infecting organism; or 4) whether infection was acute postoperative versus hematogenous. METHODS: Of revision TKAs from 2004 to 2012 (n = 1735), 76 underwent irrigation and debridement (I&D) with liner exchange after primary TKA with mean 3.5-year follow-up. We analyzed those requiring reoperation for infection (n = 21) versus those who did not (n = 55). RESULTS: Increased duration of postoperative antibiotic therapy (p = 0.0163) decreased reoperation for infection. Atrial fibrillation (p = 0.0053), chronic obstructive pulmonary disease (COPD) (p = 0.0122), more than 15 cells per high powered field (HPF) (p = 0.0124), or higher preoperative C-reactive protein (p = 0.0025) increased reoperation for infection. Incidence of infection recurrence was highest with Methicillin resistant S. aureus (MRSA) and lowest with Gram negative organisms. There was no difference in reoperation-free survival between acute postoperative and hematogenous infections. CONCLUSION: Reoperation-free survival following I&D with polyethylene liner exchange of acutely infected primary TKA: 1) improves with increased postoperative antibiotic therapy duration so chronic antibiotic suppression should be considered following TKA I&D with liner exchange; 2) is worse with atrial fibrillation, COPD, >15 cells/HPF, preoperative C-reactive protein >500 mg/L, or MRSA so two-stage revision may be favored in these patients; and 3) is equivalent in acute postoperative and hematogenous infections.
    [Abstract] [Full Text] [Related] [New Search]