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The outcomes of acute periprosthetic joint infection following unicompartmental knee replacement managed with early debridement, Antibiotics, and implant retention.
Asadollahi, S; Hamilton, T W; Sabah, S A; Scarborough, M; Price, A J; Gibbons, C L M H; Murray, D W; Alvand, A.
Afiliación
  • Asadollahi S; Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford, OX3 7LD, UK.
  • Hamilton TW; Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford, OX3 7LD, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK.
  • Sabah SA; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK.
  • Scarborough M; Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford, OX3 7LD, UK.
  • Price AJ; Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford, OX3 7LD, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK.
  • Gibbons CLMH; Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford, OX3 7LD, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK.
  • Murray DW; Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford, OX3 7LD, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK.
  • Alvand A; Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford, OX3 7LD, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK. Electronic address: Abtin.Alvand@ouh.nhs.uk.
Knee ; 47: 13-20, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38171207
ABSTRACT

BACKGROUND:

Periprosthetic joint infection (PJI) following unicompartmental knee replacement (UKR) is an uncommon, yet serious, complication. There is a paucity of evidence regarding the effectiveness of Debridement-Antibiotics-and-Implant-Retention (DAIR) in this setting. The aim of this study is to investigate the effectiveness of DAIR for acute UKR PJI.

METHOD:

Between 2006 and 2019, 5195 UKR were performed at our institution. Over this period, sixteen patients underwent DAIR for early, acute PJI. All patients met MSIS PJI diagnostic criteria. The median age at DAIR was 67 years (range 40-73) and 12 patients were male (75.0%). The median time to DAIR was 24 days (range 6-60). Patients were followed up for a median of 6.5 years (range1.4-10.5) following DAIR.

RESULTS:

0.3% (16/5195) of UKR in our institution had a DAIR within 3 months. 15 of 16 patients (93.8%) were culture positive, with the most common organism MSSA (n = 8, 50.0%). Patients were treated with an organism-specific intravenous antibiotic regime for a median of 6 weeks, followed by oral antibiotics for a median duration of 6 months. The Kaplan-Meier survivor estimate for revision for PJI was 57% (95%CI 28-78%) at five years, and survivor estimate for all cause revision 52% (95%CI 25-74%).The median Oxford Knee Score for patients with a viable implant at final follow-up was 45 points (range 39-46).

CONCLUSION:

Early, acute PJI after UKR is rare. DAIR had a moderate success rate, with infection-free survivorship of 57% at 5 years. Those successfully treated with DAIR had excellent functional outcome and implant survival.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Relacionadas con Prótesis / Artroplastia de Reemplazo de Rodilla / Desbridamiento / Prótesis de la Rodilla / Antibacterianos Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Knee Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Relacionadas con Prótesis / Artroplastia de Reemplazo de Rodilla / Desbridamiento / Prótesis de la Rodilla / Antibacterianos Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Knee Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos