Clin Orthop Surg.  2015 Mar;7(1):69-76. 10.4055/cios.2015.7.1.69.

The Parameters Affecting the Success of Irrigation and Debridement with Component Retention in the Treatment of Acutely Infected Total Knee Arthroplasty

• Kim JG
• Bae JH
• Lee SY
• Cho WT
• Lim HC

• KMID: 2069877
• DOI: http://doi.org/10.4055/cios.2015.7.1.69

Abstract

BACKGROUND
The aims of our study were to evaluate the success rate of irrigation and debridement with component retention (IDCR) for acutely infected total knee arthroplasty (TKA) (< 4 weeks of symptom duration) and to analyze the factors affecting prognosis of IDCR.
METHODS
We retrospectively reviewed 28 knees treated by IDCR for acutely infected TKA from 2003 to 2012. We evaluated the success rate of IDCR. All variables were compared between the success and failure groups. Multivariable logistic regression analysis was also used to examine the relative contribution of these parameters to the success of IDCR.
RESULTS
Seventeen knees (60.7%) were successfully treated. Between the success and failure groups, there were significant differences in the time from primary TKA to IDCR (p = 0.021), the preoperative erythrocyte sedimentation rate (ESR; p = 0.021), microorganism (p = 0.006), and polyethylene liner exchange (p = 0.017). Multivariable logistic regression analysis of parameters affecting the success of IDCR demonstrated that preoperative ESR (odds ratio [OR], 1.02; p = 0.041), microorganism (OR, 12.4; p = 0.006), and polyethylene liner exchange (OR, 0.07; p = 0.021) were significant parameters.
CONCLUSIONS
The results show that 60.7% of the cases were successfully treated by IDCR for acutely infected TKA. The preoperative ESR, microorganism, and polyethylene liner exchange were factors that affected the success of IDCR in acutely infected TKA.

Keyword

Knee; Arthroplasty; Debridement

MeSH Terms

Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents/therapeutic use
Arthroplasty, Replacement, Knee/*adverse effects
Arthroscopy
Debridement
Female
Humans
Joint Diseases/microbiology/surgery/therapy
Knee Joint/microbiology/*surgery
Knee Prosthesis/microbiology
Male
Middle Aged
Prosthesis-Related Infections/etiology/microbiology/*therapy
Retrospective Studies
Therapeutic Irrigation
Treatment Outcome
Anti-Bacterial Agents

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