Factors influencing the outcome of deep infection following total knee arthroplasty

• Published in: The knee Vol. 22; no. 4; pp. 328 - 332
• Main Authors: Nakano, Naoki, Matsumoto, Tomoyuki, Ishida, Kazunari, Tsumura, Nobuhiro, Muratsu, Hirotsugu, Hiranaka, Takafumi, Kuroda, Ryosuke, Kurosaka, Masahiro
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.09.2015; Elsevier Limited
• Subjects: Aged; Arthroplasty, Replacement, Knee - adverse effects; Clinical outcome; Confidence intervals; Deep infection; Female; Follow-Up Studies; Hospitals; Humans; Incidence; Japan - epidemiology; Joint surgery; Knee; Knee Prosthesis - adverse effects; Male; Organisms; Orthopedics; Osteoarthritis, Knee - surgery; Prostheses; Prosthesis-Related Infections - epidemiology; Prosthesis-Related Infections - etiology; Prosthetic joint infection; Retention; Retrospective Studies; Risk Assessment; Risk Factors; Staphylococcus infections; Total knee arthroplasty (TKA); Japan; Deep infection; Clinical outcome; Prosthetic joint infection; Total knee arthroplasty (TKA); Risk factors
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2015.04.005

Abstract Background Whereas clinical studies have revealed a number of important risk factors for postoperative infection following total knee arthroplasty (TKA), it is unclear which factor influences clinical results. A multicenter study was therefore performed by reviewing 51 patients with deep infection after TKA and seeking for the factors related to clinical outcomes. Methods Fifty-one deep infections after TKA were treated from 2000 to 2011 at the multicenter including a university or three arthroplasty centers. Among them, two clinical outcome measures including retention of prosthesis at initial treatment and functional prosthetic knee were assessed for several factors such as age, sex, primary diagnosis, onset time after primary TKA, type of hospital where the primary TKA was performed and the organism's resistance to methicillin using the logistic regression analysis model. Results Among the factors, type of hospital where the primary TKA was performed and onset time after primary TKA had higher multivariable-adjusted odds ratios (ORs) for retention of primary prosthesis (ORs 35.21 and 11.69, respectively.). The cases which primary surgery were performed in arthroplasty centers had higher multivariable-adjusted ORs for functional prosthetic knee (OR 4.9). Thirty-one infection cases with non-methicillin-resistant organisms were all able to keep functional prosthetic knee after the operation, whereas 13 out of 20 infection cases with methicillin-resistant organisms lost their knee function after the operation. Conclusions Onset time after primary TKA, type of hospital where the primary surgery was performed and the organism's resistance to methicillin are important factors influencing the clinical outcomes after infected TKA. Level of Evidence Level 3. Retrospective comparative study.