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Results of infected total knee arthroplasty treated with arthroscopic debridement and continuous antibiotic irrigation system

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Abstract

Background

Arthroscopic debridement with continuous irrigation system was used with success in treating infective arthritis. We evaluated the effectiveness of arthroscopic debridement coupled with antibiotic continuous irrigation system in acute presentation of late infected total knee arthroplasty.

Materials and Methods

We performed a retrospective review of medical record of patients with acute presentation of late infected total knee arthroplasty who were treated by arthroscopic debridement coupled with continuous postoperative antibiotic irrigation system.

Results

Seventeen patients were included in our study. 15 (88%) patients preserved their total knee prosthesis at mean of followup of 27.5 months (range, 14–28 months). Two (12%) patients failed arthroscopic protocol and finally needed two stages revision. Our study showed an 88% prosthesis retention rate in patients with acute presentation of late prosthetic knee infection. No complication was associated with use of antibiotic irrigation system.

Conclusion

Arthroscopic debridement combined with continuous antibiotic irrigation and suction is an effective treatment for patients with acute presentation of late infected total knee arthroplasty.

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References

  1. Kettlekamp DB. Infected total knee replacement (editorial). Arch Surg 1977;112:552–3.

    Article  CAS  Google Scholar 

  2. Wilson MG, Kelley K, Thornhill TS. Infection as a complication of total knee-replacement arthroplasty. Risk factors and treatment in sixty-seven cases. J Bone Joint Surg Am 1990;72:878–83.

    Article  CAS  Google Scholar 

  3. Anguita-Alonso P, Rouse MS, Piper KE, Jacofsky DJ, Osmon DR, Patel R. Comparative study of antimicrobial release kinetics from polymethylmethacrylate. Clin Orthop Relat Res 2006;445:239–44.

    PubMed  Google Scholar 

  4. Jamsen E, Huhtala H, Puolakka T, Moilanen T. Risk factors for infection after knee arthroplasty. A register-based analysis of 43, 149 cases. J Bone Joint Surg Am 2009;91:38–47.

    Article  Google Scholar 

  5. McCleery MA, Leach WJ, Norwood T. Rates of infection and revision in patients with renal disease undergoing total knee replacement in Scotland. J Bone Joint Surg Br 2010;92:1535–9.

    Article  CAS  Google Scholar 

  6. Phillips JE, Crane TP, Noy M, Elliott TS, Grimer RJ. The incidence of deep prosthetic infections in a specialist orthopaedic hospital: A 15-year prospective survey. J Bone Joint Surg Br 2006;88:943–8.

    Article  CAS  Google Scholar 

  7. Estes CS, Beauchamp CP, Clarke HD, Spangehl MJ. A two-stage retention debridement protocol for acute periprosthetic joint infections. Clin Orthop Res 2010;468:2029–38.

    Article  Google Scholar 

  8. Insall JN, Thompson F, Brause BD. Two-stage reimplantation for the salvage of infected total knee arthroplasty. J Bone Joint Surg Am 1983;65:1078–98.

    Google Scholar 

  9. Mont MA, Waldman B, Banerjee C, Pacheco IH, Hungerford DS. Multiple irrigation, debridement, and retention of components in infected total knee arthroplasty A two-stage retention debridement protocol for acute periprosthetic joint infections. J Arthroplasty 1997;12:426–33.

    Article  CAS  Google Scholar 

  10. Morrey BF, Westholm F, Schoifet S, Rand JA, Bryan RS. Long term results of various treatment options for infected total knee arthroplasty. Clin Ortho Res 1989;248:120–8.

    Google Scholar 

  11. Rand JA. Alternatives to reimplantation for salvage of the total knee arthroplasty complicated by infection. J Bone Joint Surg Am 1993;75:282–9.

    Article  CAS  Google Scholar 

  12. Deirmengian C, Greenbaum J, Stern J, Braffman M, Lotke PA, Booth RE Jr, et al. Open debridement of acute gram-positive infections after total knee arthroplasty. Clin Orthop Relat Res 2003;416:129–34.

    Article  Google Scholar 

  13. Choi HR, von Knoch F, Zurakowski D, Nelson SB, Malchau H. Can implant retention be recommended for treatment of infected TKA? Clin Orthop Relat Res 2011;469:961–9.

    Article  Google Scholar 

  14. Waldman BJ, Hostin E, Mont MA, Hungerford DS. Infected total knee arthroplasty treated by arthroscopic irrigation and debridement. J Arthroplasty 2000;15:430–6.

    Article  CAS  Google Scholar 

  15. Flood JN, Kolarik DB. Arthroscopic irrigation and debridement of infected total knee arthroplasty: Report of two cases. Arthroscopy 1988;4:182–6.

    Article  CAS  Google Scholar 

  16. Kim YH, Choi Y, Kim JS. Treatment based on the type of infected TKA improves infection control. Clin Orthop Relat Res 2011;469:977–84.

    Article  Google Scholar 

  17. Windsor RE, Insall JN, Urs WK, Miller DV, Brause BD. Two-stage reimplantation for the salvage of total knee arthroplasty complicated by infection. Further followup and refinement of indications. J Bone Joint Surg Am 1990;72:272–8.

    Article  CAS  Google Scholar 

  18. Rand JA, Bryan RS. Reimplantation for the salvage of an infected total knee arthroplasty. J Bone Joint Surg Am 1983;65:1081–6.

    Article  CAS  Google Scholar 

  19. Ilahi OA, Al-Habbal GA, Bocell JR, Tullos HS, Huo MH. Arthroscopic debridement of acute periprosthetic septic arthritis of the knee. Arthroscopy 2005;21:303–6.

    Article  Google Scholar 

  20. Jackson RW, Parsons CJ. Distension-irrigation treatment of major joint sepsis. Clin Orthop Relat Res 1973;96:160–4.

    Google Scholar 

  21. Kuo CL, Chang JH, Wu CC, Shen PH, Wang CC, Lin LC, et al. Treatment of septic knee arthritis: Comparison of arthroscopic debridement alone or combined with continuous closed irrigation-suction system. J Trauma 2010;71:454–9.

    Article  Google Scholar 

  22. McLaren RI, McLaren AC, Vernon BL. Generic tobramycin elutes from bone cement faster than proprietary tobramycin. Clin Orthop Relat Res 2008;466:1372–6.

    Article  CAS  Google Scholar 

  23. Salvati EA, Callaghan JJ, Brause BD, Klein RF, Small RD. Reimplantation in infection. Elution of gentamicin from cement and beads. Clin Orthop Relat Res 1986;207:83–93.

    Google Scholar 

  24. van de Belt H, Neut D, Schenk W, van Horn JR, van der Mei HC, Busscher HJ. Gentamicin release from polymethylmethacrylate bone cements and Staphylococcus aureus biofilm formation. Acta Orthop Scand 2000;71:625–9.

    Article  Google Scholar 

  25. Whiteside LA, Peppers M, Nayfeh TA, Roy ME. Methicillin-resistant Staphylococcus aureus in TKA treated with revision and direct intraarticular antibiotic infusion. Clin Orthop Relat Res 2011;469:26–33.

    Article  Google Scholar 

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Correspondence to Leou-Chyr Lin.

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Liu, CW., Kuo, CL., Chuang, SY. et al. Results of infected total knee arthroplasty treated with arthroscopic debridement and continuous antibiotic irrigation system. IJOO 47, 93–97 (2013). https://doi.org/10.4103/0019-5413.106925

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