The Fate of Acute Methicillin-Resistant Staphylococcus aureus Periprosthetic Knee Infections Treated by Open Debridement and Retention of Components

Abstract The success of open irrigation and debridement with component retention (ODCR) for acute periprosthetic knee joint infection varies widely. The species and virulence of the infecting organism have been shown to influence outcome. This multicenter, retrospective study identified 19 cases of...

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Published in	The Journal of arthroplasty Vol. 24; no. 6; pp. 101 - 104
Main Authors	Bradbury, Thomas, MD, Fehring, Thomas K., MD, Taunton, Michael, MD, Hanssen, Arlen, MD, Azzam, Khalid, MD, Parvizi, Javad, MD, Odum, Susan M., MEd
Format	Journal Article
Language	English
Published	United States Elsevier Inc 01.09.2009
Subjects	Anti-Bacterial Agents - therapeutic use Arthroplasty, Replacement, Knee - adverse effects Arthroplasty, Replacement, Knee - instrumentation Debridement Humans Methicillin-Resistant Staphylococcus aureus MRSA open debridement Orthopedics Prosthesis-Related Infections - microbiology Prosthesis-Related Infections - therapy retention of components Staphylococcal Infections - microbiology Staphylococcal Infections - therapy TKA Treatment Outcome Vancomycin - therapeutic use TKA open debridement retention of components MRSA
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Abstract	Abstract The success of open irrigation and debridement with component retention (ODCR) for acute periprosthetic knee joint infection varies widely. The species and virulence of the infecting organism have been shown to influence outcome. This multicenter, retrospective study identified 19 cases of acute periprosthetic methicillin-resistant Staphylococcus aureus (MRSA) knee infections managed by ODCR and at least 4 weeks of postoperative intravenous vancomycin therapy. At minimum follow-up of 2 years, the treatment failed to eradicate the infection in 16 cases (84% failure rate). Of those 16 failures, 13 patients required a 2-stage exchange arthroplasty, 2 patients required repeat incision and debridement with antibiotic suppression, and 1 patient died of MRSA sepsis. In addition, a systematic review of the literature revealed failure to eradicate infection in 10 of 13 patients managed with a similar protocol. The total success rate of ODCR in acute periprosthetic MRSA knee infection was 18%.
AbstractList	Abstract The success of open irrigation and debridement with component retention (ODCR) for acute periprosthetic knee joint infection varies widely. The species and virulence of the infecting organism have been shown to influence outcome. This multicenter, retrospective study identified 19 cases of acute periprosthetic methicillin-resistant Staphylococcus aureus (MRSA) knee infections managed by ODCR and at least 4 weeks of postoperative intravenous vancomycin therapy. At minimum follow-up of 2 years, the treatment failed to eradicate the infection in 16 cases (84% failure rate). Of those 16 failures, 13 patients required a 2-stage exchange arthroplasty, 2 patients required repeat incision and debridement with antibiotic suppression, and 1 patient died of MRSA sepsis. In addition, a systematic review of the literature revealed failure to eradicate infection in 10 of 13 patients managed with a similar protocol. The total success rate of ODCR in acute periprosthetic MRSA knee infection was 18%. The success of open irrigation and debridement with component retention (ODCR) for acute periprosthetic knee joint infection varies widely. The species and virulence of the infecting organism have been shown to influence outcome. This multicenter, retrospective study identified 19 cases of acute periprosthetic methicillin-resistant Staphylococcus aureus (MRSA) knee infections managed by ODCR and at least 4 weeks of postoperative intravenous vancomycin therapy. At minimum follow-up of 2 years, the treatment failed to eradicate the infection in 16 cases (84% failure rate). Of those 16 failures, 13 patients required a 2-stage exchange arthroplasty, 2 patients required repeat incision and debridement with antibiotic suppression, and 1 patient died of MRSA sepsis. In addition, a systematic review of the literature revealed failure to eradicate infection in 10 of 13 patients managed with a similar protocol. The total success rate of ODCR in acute periprosthetic MRSA knee infection was 18%. The success of open irrigation and debridement with component retention (ODCR) for acute periprosthetic knee joint infection varies widely. The species and virulence of the infecting organism have been shown to influence outcome. This multicenter, retrospective study identified 19 cases of acute periprosthetic methicillin-resistant Staphylococcus aureus (MRSA) knee infections managed by ODCR and at least 4 weeks of postoperative intravenous vancomycin therapy. At minimum follow-up of 2 years, the treatment failed to eradicate the infection in 16 cases (84% failure rate). Of those 16 failures, 13 patients required a 2-stage exchange arthroplasty, 2 patients required repeat incision and debridement with antibiotic suppression, and 1 patient died of MRSA sepsis. In addition, a systematic review of the literature revealed failure to eradicate infection in 10 of 13 patients managed with a similar protocol. The total success rate of ODCR in acute periprosthetic MRSA knee infection was 18%.
Author	Azzam, Khalid, MD Fehring, Thomas K., MD Parvizi, Javad, MD Odum, Susan M., MEd Hanssen, Arlen, MD Bradbury, Thomas, MD Taunton, Michael, MD
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Snippet	Abstract The success of open irrigation and debridement with component retention (ODCR) for acute periprosthetic knee joint infection varies widely. The... The success of open irrigation and debridement with component retention (ODCR) for acute periprosthetic knee joint infection varies widely. The species and...
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SubjectTerms	Anti-Bacterial Agents - therapeutic use Arthroplasty, Replacement, Knee - adverse effects Arthroplasty, Replacement, Knee - instrumentation Debridement Humans Methicillin-Resistant Staphylococcus aureus MRSA open debridement Orthopedics Prosthesis-Related Infections - microbiology Prosthesis-Related Infections - therapy retention of components Staphylococcal Infections - microbiology Staphylococcal Infections - therapy TKA Treatment Outcome Vancomycin - therapeutic use
Title	The Fate of Acute Methicillin-Resistant Staphylococcus aureus Periprosthetic Knee Infections Treated by Open Debridement and Retention of Components
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