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Megaprostheses for TKA yielded significant complications among septic patients

Issue: September 2018

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PHILADELPHIA — Patients undergoing total knee arthroplasty experienced significant complications when a megaprosthesis was used for septic indications, according to results presented at the Musculoskeletal Infection Society Annual Open Scientific Meeting.

Carlos Higuera-Rueda

Carlos Higuera-Rueda, MD, and colleagues classified 143 patients treated with megaprostheses for non-tumor indications between 2008 and 2016 as either septic or aseptic. Researchers measured early outcomes, including 90-day non-surgical and surgical complications, length of stay, discharge disposition, readmissions and reoperations, as well as long-term outcomes of mortality, implant survivorship and functional outcomes, including modified Knee Society scores.

Higuera-Rueda noted patients in the septic cohort were older, had a higher BMI, more previous surgeries and more immunosuppressant disease. He also noted differences in readmission rate, discharge destination and infection between the two groups.

“Almost 30% of cases in the septic cohort had an infection within 90 days,” Higuera-Rueda said in his presentation.

In addition, approximately 33% of patients in the septic cohort underwent revision for infection, he said. Compared with the aseptic cohort, according to Higuera-Rueda, the septic cohort had an almost 400% higher chance of having a revision. He noted they found similar results when it came to mortality.

“When we looked at Kaplan Meier survivorship, aseptic indication had a 76% survivorship at 120 months whereas, the septic indication, only 36% survivorship at 120 months,” Higuera-Rueda said. – by Casey Tingle

Reference:

Yakubek G, et al. Total knee arthroplasty megaprosthesis in non-tumor patients – Are septic indications worth the effort? Presented at: Musculoskeletal Infection Society Annual Open Scientific Meeting; July 27-28, 2018; Philadelphia.

Disclosure: Higuera-Rueda reports no relevant financial disclosures.