Chronic lymphedema among strongest predictors of post-TKA periprosthetic reinfection

Kubista B, et al. Int Orthop. Published online May 20, 2011. doi: 10.1007/s00264-011-1267-x.

Chronic lymphedema and revision done between resection and definitive reimplantation were found to be the strongest predictors of treatment failure in periprosthetic infection of total knee arthroplasty, according to investigators in Rochester, Minn.

The investigators performed a retrospective prognostic study on 368 patients who underwent a two-stage revision treatment protocol of an infected total knee arthroplasty (TKA) between 1998 and 2006. According to the study abstract, the team selected only patients who developed recurrent infection and compared them against a randomly-selected control group to assess risk factors of treatment failure.

The authors noted that 58 patients (15.8%) developed reinfection following two-stage reimplantation, with a median reported time to reinfection of 1,303 days (3.6 years).

“The strongest positive predictors of treatment failure included chronic lymphedema and revision between resection and definitive reimplantation,” the authors wrote.

Ultimately, the authors concluded their findings could be used to potentially counsel patients being considered for two-stage exchange for infected TKA with regard to prognosis. Further, the findings could “provide a basis for future comparisons,” they noted.