Risk determinants of uncontrolled PJI of knee after two-stage reimplantation

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Created On: 20/06/2020

Risk determinants of uncontrolled PJI of knee after two-stage reimplantation

This research focused to examine the treatment outcomes of following two-stage knee reimplantation and classify the risk factors for uncontrolled PJI of knees.

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Key take away

Periprosthetic infection (PJI) following TKA poses as a serious problem, and doctors should recognize the associated risk factors to prevent its relapse. This present study found that 17 out of 70 patients developed recurrent infections after reimplantation; with wound issues, fungal species, etc. as risk determinants/factors for the same. This can help in advising patients and physicians for a better understanding and taking caution in PJI treatment.

Background

This research focused to examine the treatment outcomes of following two-stage knee reimplantation and classify the risk factors for uncontrolled PJI of knees.

Method

All in all, seventy knees diagnosed with a PJI treated with two-stage reimplantation were retrospectively reviewed. Following reimplantation, the patients in group C i.e. controlled infection group needed no further medication or surgical treatment in 2 years. Group U patients i.e. uncontrolled infection group portrayed symptoms of active infection following the resection arthroplasty or were again infected after 2-stage reimplantation. A comparison of group C and group U was done and potential risk factors for uncontrolled PJI were investigated.

Result

At follow-up, 53 (75.7%) knees were clinically considered free from infection at the latest follow-up. The rest 17 knees (24.3%) needed extra surgical procedures after the 2-stage reimplantation. No statistically significant difference was found between the groups, considering the demographics. Group U had statistically more common wound issues (p = 0.030). Between groups C and U, pre-reimplantation C-reactive protein (CRP) was statistically different (0.44 and 1.70, p = 0.025). Fungus species was statistically more prevalent in group U than group C (p = 0.031).

Conclusion

In the included cases, the reinfection rate of our two-stage reimplantation protocol was 24.3%. Group U had statistically more common wound complications, higher pre-reimplantation CRP levels, and fungus species were than with group C.