Predictors of Treatment Failure After 2-Stage Reimplantation for Infected Total Knee Arthroplasty: A 2- to 10-Year Follow-Up.
J Arthroplasty
; 33(7): 2234-2239, 2018 07.
Article
em En
| MEDLINE
| ID: mdl-29572036
ABSTRACT
BACKGROUND:
The aim of this study is to identify risk factors which may lead to treatment failure following 2-stage reimplantation for chronic infected total knee arthroplasty (TKA).METHODS:
We retrospectively reviewed 106 patients (108 knees) who underwent consecutive 2-stage revision for chronic PJI of the knee at our institution between January 2005 and December 2015. A total of 31 risk factors, including patient characteristics, comorbidities, surgical variables, and microbiology data, were collected. Kaplan-Meier survival and Cox regression analyses were used to calculate survival rates and adjusted hazard ratios (HRs) of treatment failure.RESULTS:
Within the cohort, 16 of the 108 2-stage reimplantations (14.8%) had treatment failure. The treatment success for 2-stage reimplantation was 91% (95% confidence interval [CI] 0.8-1.0) at 2 years and 84% (95% CI 0.8-0.9) at 5 and 10 years. Multivariate analysis provided the strongest predictors of treatment failure, including body mass index ≥30 kg/m2 (adjusted HR 9.3, 95% CI 2.7-31.8, P < .001), operative time >4 hours (adjusted HR 11.3, 95% CI 3.9-33.1, P < .001), gout (adjusted HR 13.8, 95% CI 2.9-66.1, P = .001), and the presence of Enterococcus species during resection arthroplasty (adjusted HR 14.1, 95% CI 2.6-76.3, P = .002).CONCLUSION:
Our study identified 4 potential risk factors that may predict treatment failure following 2-stage revision for chronic knee PJI. This finding may be useful when counseling patients regarding the treatment success and prognosis of 2-stage reimplantation for infected TKA.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Reoperação
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Artrite Infecciosa
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Infecções Relacionadas à Prótese
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Artroplastia do Joelho
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Prótese do Joelho
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
J Arthroplasty
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Taiwan