Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2024
Prevalence of unexpected intraoperative cultures (UPIC) in revision total knee arthroplasty (TKA) and risk of periprosthetic joint infection (PJI).
Prevalence of unexpected positive intraoperative cultures (UPIC) in revision total knee arthroplasty (TKA) is reported to be 8.32% with largely varying findings in individual studies (5.92-62.07%) due to a heterogeneity in preoperative diagnostic work-up and diagnostic criteria for periprosthetic joint infection (PJI). When diagnosed as unsuspected PJI, re-revision rate is reported to be as high as 18.45% compared to 2.94% in patients with UPIC classified as contamination (p = 0.0237). We performed a monocentric retrospective analysis of revision TKA surgery to determine prevalence of UPIC, risk of developing a subsequent PJI and re-revision rate after 24 months compared to those without UPIC. ⋯ Presence of UPIC in presumed aseptic revision TKA does not correlate with a lower survival rate, but a higher incidence of subsequent PJI was observed in cases interpreted as unsuspected PJI.
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Arch Orthop Trauma Surg · Dec 2024
How reliable is the soft tissue radiological knee index in predicting superficial surgical site infection following total knee arthroplasty?
The purpose of this study was to evaluate the association between the Soft Tissue Radiological Knee (SToRK) Index and the risk of developing a superficial surgical site infection (SSSI) following primary total knee arthroplasty (TKA). ⋯ The SToRK Index can be used as an additional tool in assessing the risk for SSSI after TKA. It might be more predictive in females due to the different fat distribution compared to males.
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Arch Orthop Trauma Surg · Dec 2024
Predictors of outcome following two-stage revision total knee arthroplasty.
Two stage revision arthroplasty remains the gold standard for peri-prosthetic joint infections of the knee. However, the functional outcomes of revision surgeries and the factors governing them require further investigation. The purpose of this study was to (a) evaluate impact of early and late stage I surgery and interval between stage I and stage II; (b) understand the impact of infecting organism and resistance; (c) to estimate long term survivorship and causes of failure. ⋯ Two-stage revision arthroplasty produced good functional outcomes when the infection was caused by single sensitive organism that did not exhibit high resistance to antibiotics. Stage I performed within 4 weeks and the subsequent re-implantation procedure undertaken within 6 weeks demonstrated better outcomes.
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Arch Orthop Trauma Surg · Dec 2024
ReviewHigh mortality rate and restricted mobility in above knee amputation following periprosthetic joint infection after total knee arthroplasty: A systematic review.
To systematically review the literature on the outcomes of above knee amputation as a salvage procedure after periprosthetic joint infection in total knee arthroplasty. ⋯ AKA due to PJI following TKA is associated with restricted mobility and high mortality rate. Polymicrobial infections and MRSA were identified as common infecting organisms, emphasizing the complexities and challenges associated with managing these infections. The reported functional outcomes, ambulatory status, complications, reoperations, and mortality rates highlight the importance of providing comprehensive, individualized care to these patients.