The Fate of Acute Methicillin-Resistant Staphylococcus aureus Periprosthetic Knee Infections Treated by Open Debridement and Retention of Components
Section snippets
Materials and Methods
A multicenter retrospective review of acute periprosthetic MRSA knee infections from 1990 to 2007 at 4 institutions was performed. Cases were identified through databases maintained by hospital infection monitoring systems or through institutional joint registries. Institutional review board approval was obtained from each center.
Inclusion criteria were designed to capture only acute periprosthetic infection cases that were managed with a specific treatment protocol. This protocol is based on
Results
Of the 19 cases that satisfied the inclusion criteria, 16 failed. The failure rate of treatment with open debridement with component retention and at least 4 weeks of intravenous vancomycin was 84%. Of the 16 failures, 13 (68%) required component resection and antibiotic impregnated spacer placement to control their infection, 2 required a repeat debridement procedure, and 1 patient died secondary to MRSA sepsis. The average duration of infection symptoms before debridement for the entire group
Discussion
The theoretical advantages of open debridement with retention of prosthetic components over a 2-stage exchange procedure in the setting of an acute prosthetic joint infection are numerous: fewer operations, less expense, conservation of bone stock, and better function of the knee during treatment. Unfortunately, success rates of open debridement and component retention are inconsistent and have varied widely ranging from 12% to 80% 2, 8, 10. The inconsistency of reported success rates produces
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2024, Orthopedic Clinics of North America
No benefits or funds were received in support of the study.