Multistage revision TKA for chronic PJI may yield high remission rates, low mortality
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Key takeaways:
- Multistage revision arthroplasty was associated with high remission rates and low mortality for patients with ongoing joint infection.
- Patients had a remission rate of 87.3% and a mortality rate of 11.4%.
For patients with chronic periprosthetic joint infection, multistage revision total knee arthroplasty procedures were associated with high remission rates and low mortality at minimum 5-year follow-up, according to published results.
Matthias Schnetz, MD, from the department of trauma and orthopaedic surgery at Berufsgenossenschaftliche Unfallklinik Frankfurt am Main in Germany, and colleagues analyzed data from 79 patients with chronic PJI of the knee who underwent a multistage revision TKA with a rotating hinge implant.
“In difficult-to-treat PJI, ongoing signs of infection after implant removal may be present,” Schnetz and colleagues wrote in the study. “In these cases, additional surgical debridement and spacer exchange steps are necessary, resulting in a multistage approach.”
According to the study, the mean number of surgeries was 3.8, which included implant removal and revision arthroplasty procedures, and the mean duration from implant removal to revision arthroplasty was 83.4 days.
Schnetz and colleagues assessed Knee Society Score (KSS), WOMAC score, complications, remissions and mortality at a minimum follow-up of 5 years. Mean follow-up of the study was 8.1 years.
Overall, 30.4% of patients (n = 24) underwent revision arthroplasty at a mean 98.7 weeks after implant removal. At follow-up, Schnetz and colleagues found the infection-free remission rate was 87.3% and mortality rate was 11.4%. They also found patients had a mean KSS of 74.3, mean KSS function score of 60.8 and mean WOMAC score of 30.2.
“Our data may be used to improve treatment for chronic PJI of the knee, and surgeons should be aware of the outcome presented when deciding on optimal therapeutic strategies,” Schnetz and colleagues concluded.
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