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1.5-Stage Exchange Arthroplasty for Total Knee Arthroplasty Periprosthetic Joint Infections.

Publication ,  Journal Article
Hernandez, NM; Buchanan, MW; Seyler, TM; Wellman, SS; Seidelman, J; Jiranek, WA
Published in: J Arthroplasty
March 2021

BACKGROUND: Periprosthetic joint infection (PJI) in total knee arthroplasty (TKA) is a challenging problem. The purpose of this study was to outline a novel technique to treat TKA PJI. We define 1.5-stage exchange arthroplasty as placing an articulating spacer with the intent to last for a prolonged time. METHODS: A retrospective review was performed from 2007 to 2019 to evaluate patients treated with 1.5-stage exchange arthroplasty for TKA PJI. Inclusion criteria included: articulating knee spacer(s) remaining in situ for 12 months and the patient deferring a second-stage reimplantation because the patient had acceptable function with the spacer (28 knees) or not being a surgical candidate (three knees). Thirty-one knees were included with a mean age of 63 years, mean BMI 34.4 kg/m2, 12 were female, with a mean clinical follow-up of 2.7 years. Cobalt-chrome femoral and polyethylene tibial components were used. We evaluated progression to second-stage reimplantation, reinfection, and radiographic outcomes. RESULTS: At a mean follow-up of 2.7 years, 25 initial spacers were in situ (81%). Five knees retained their spacer(s) for some time (mean 1.5 years) and then underwent a second-stage reimplantation; one of the five had progressive radiolucent lines but no evidence of component migration. Three knees (10%) had PJI reoccurrence. Four had progressive radiolucent lines, but there was no evidence of component migration in any knees. CONCLUSIONS: 1.5-stage exchange arthroplasty may be a reasonable method to treat TKA PJI. At a mean follow-up of 2.7 years, there was an acceptable rate of infection recurrence and implant durability.

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Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

March 2021

Volume

36

Issue

3

Start / End Page

1114 / 1119

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Reoperation
  • Prosthesis-Related Infections
  • Orthopedics
  • Middle Aged
  • Male
  • Knee Prosthesis
  • Knee Joint
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hernandez, N. M., Buchanan, M. W., Seyler, T. M., Wellman, S. S., Seidelman, J., & Jiranek, W. A. (2021). 1.5-Stage Exchange Arthroplasty for Total Knee Arthroplasty Periprosthetic Joint Infections. J Arthroplasty, 36(3), 1114–1119. https://doi.org/10.1016/j.arth.2020.09.048
Hernandez, Nicholas M., Michael W. Buchanan, Thorsten M. Seyler, Samuel S. Wellman, Jessica Seidelman, and William A. Jiranek. “1.5-Stage Exchange Arthroplasty for Total Knee Arthroplasty Periprosthetic Joint Infections.J Arthroplasty 36, no. 3 (March 2021): 1114–19. https://doi.org/10.1016/j.arth.2020.09.048.
Hernandez NM, Buchanan MW, Seyler TM, Wellman SS, Seidelman J, Jiranek WA. 1.5-Stage Exchange Arthroplasty for Total Knee Arthroplasty Periprosthetic Joint Infections. J Arthroplasty. 2021 Mar;36(3):1114–9.
Hernandez, Nicholas M., et al. “1.5-Stage Exchange Arthroplasty for Total Knee Arthroplasty Periprosthetic Joint Infections.J Arthroplasty, vol. 36, no. 3, Mar. 2021, pp. 1114–19. Pubmed, doi:10.1016/j.arth.2020.09.048.
Hernandez NM, Buchanan MW, Seyler TM, Wellman SS, Seidelman J, Jiranek WA. 1.5-Stage Exchange Arthroplasty for Total Knee Arthroplasty Periprosthetic Joint Infections. J Arthroplasty. 2021 Mar;36(3):1114–1119.
Journal cover image

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

March 2021

Volume

36

Issue

3

Start / End Page

1114 / 1119

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Reoperation
  • Prosthesis-Related Infections
  • Orthopedics
  • Middle Aged
  • Male
  • Knee Prosthesis
  • Knee Joint
  • Humans