[Infected Knee Arthroplasty. A Treatment Algorithm at the Kantonsspital Liestal, Switzerland]

Overview

Journal Orthopade

Specialty Orthopedics

Date 2006 Jul 13

PMID 16835763

Citations 10

Authors

T B Maurer

P E Ochsner

Affiliations

Soon will be listed here.

Abstract

The algorithm differentiates between several surgical treatment options depending on the duration of the infection, on the amount of soft tissue damage, on the stability of the implant and the type of micro-organism. If the symptoms of infection exist for less then 3 weeks, a radical debridement is indicated under the condition of a stable implant and good soft tissue conditions. A one-stage exchange is possible with satisfactory conditions of soft tissue and the absence of difficult-to-treat, resistant micro-organisms. In patients with sinustracts or compromised soft tissue, a two-stage exchange is necessary. The placement of a spacer combined with a short interval of 2-3 weeks until reimplantation is possible for easy-to-treat bacteria. For difficult-to-treat micro-organisms, an interval of 8 weeks without spacer until reimplantation is necessary. While stabilised by a fixateur extern, antimicrobial treatment is administered for the first 6 weeks. If the tissue specimens at reimplantation two weeks later do not show growth of bacteria or signs of acute inflammation, antimicrobial treatment can be discontinued. For all other above-mentioned treatment protocols, we administer antimicrobial treatment for a total of 6 months. We present the results of 40 consecutive infected total knee arthroplasties treated according to our algorithm, including a detailed presentation of the two-stage revision procedure.

Citing Articles

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The stability of carbapenems before and after admixture to PMMA-cement used for replacement surgery caused by Gram-negative bacteria.

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Diagnostic work-up strategy for periprosthetic joint infections after total hip and knee arthroplasty: a 12-year experience on 320 consecutive cases.

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Evaluation of an interdisciplinary therapy algorithm in patients with prosthetic joint infections.

Wimmer M, Randau T, Petersdorf S, Pagenstert G, Weisskopf M, Wirtz D Int Orthop. 2013; 37(11):2271-8.

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[Knee joint infections].

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