Reinfection and Re-revision Rates of Periprosthetic Knee Infection Under Four Different Surgical Strategies

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-01-01

Study Completion Date

2024-12-31

Brief Summary

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A single-center retrospective cohort study was conducted in the Department of Orthopedics, the First Affiliated Hospital of Fujian Medical University. This study reviewed 145 patients who underwent debridement, antibiotics, and implant retention (DAIR), 1-stage revision, 1.5-stage revision, and 2-stage revision surgeries for total knee arthroplasty periprosthetic joint infection (TKA-PJI) at this institution between 2012 and 2022. The differences in postoperative reinfection rate, microbial composition of reinfection, short-term and long-term aseptic prosthesis survival rate, prosthesis loosening and revision rate due to any cause, and long-term loosening-free survival rate among the four revision surgical approaches for TKA-PJI were evaluated, so as to provide reference value for clinical decision-making.

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Detailed Description

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A single-center retrospective cohort study was conducted in the Department of Orthopedics, the First Affiliated Hospital of Fujian Medical University. This study reviewed 145 patients who underwent debridement, antibiotics, and implant retention (DAIR), 1-stage revision, 1.5-stage revision, and 2-stage revision surgeries for total knee arthroplasty periprosthetic joint infection (TKA-PJI) at this institution between 2012 and 2022. In this study, we aimed to evaluate: (1) the postoperative reinfection rates following four surgical strategies for TKA-PJI; (2) the microbial profile of recurrent infections; (3) short- and long-term infection-free implant survival rates across the four surgical approaches; (4) re-revision rates due to aseptic loosening and long-term aseptic loosening-free implant survival rates; and (5) the reinfection rate in patients with positive cultures at the time of reimplantation. In order to provide reference value for clinical decision-making.

Conditions

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Total Knee Arthroplasty Reinfection Aseptic Loosening Revision Periprosthetic Joint Infection (PJI)

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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DAIR group

DAIR revision involves washout, thorough debridement, antibiotics, and all components of implant retention, but polyethylene exchange

No interventions assigned to this group

1-stage revision group

One-stage revision involves open debridement of the infected knee, followed by immediate revision by removal and or reimplantation of all components

No interventions assigned to this group

1.5-stage revision group

The 1.5-stage revision involves the use of a functional, articulating antibiotic-loaded knee spacer intended for long-term retention-either indefinitely or until loosening necessitates definitive TKA revision. We standardize the terminology for this procedure as "1.5-stage revision", as it represents an intermediate strategy between one-stage and two-stage revision for the treatment of PJI following TKA

No interventions assigned to this group

2-stage revision group

Two-stage revision, with removal of implants, placement of an antibiotic spacer, and parenteral antibiotic treatment followed by TKA reimplantation has been proposed as the "gold standard" for chronic PJI treatment

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

1. Patients who met the diagnostic criteria for TKA-PJI;
2. Patients who underwent one of the following surgical interventions: DAIR, one-stage revision, 1.5-stage revision, or two-stage revision;
3. Patients with complete medical records available;
4. Patients who provided informed consent to participate in the study.

Exclusion Criteria

1. Incomplete medical records;
2. Poor follow-up compliance, including inability to complete scheduled follow-up visits or refusal to participate in follow-up;
3. Follow-up duration less than 2 years.

Eligible Sex

ALL

Accepts Healthy Volunteers

No