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Ortop Traumatol Rehabil ; 23(6): 411-416, 2021 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-35008033

RESUMO

BACKGROUND:  This study evaluates 15 years' results of the implantation of autoclaved femoral and tibial prosthesis components together with a new same brand polyethylene insert which were used as a temporary articulating spacer in patients with periprosthetic infection of total knee arthroplasty (TKA) in a two-stage reimplantation procedure in 6 patients.  Material and methods. The femoral and tibial prostheses of 6 patients with deep chronic periprosthetic infection of TKA who underwent elective two-stage exchange arthroplasty were autoclaved and reinserted with a new polyethylene insert of the same brand and bone cement mixed with tecoplanin in 2004. RESULTS: Four patients were followed for 15 years. They were all female and between 47-70 years old. The infectious agent was meticillin-resistant Staphylococcus aureus (MRSA) in 3 and coagulase negative Staphy-lococcus in one patient. Patients were invited for second stage reimplantation, but they refused to undergo the second stage. Three of them had their second stage reimplantation after 15, 13 and 10 years while one patient was reinfected after 5 years, in 2009, and arthrodesis was performed. They were all happy with the result and infection free at last follow-up.  Conclusions. 1. Regarding the results of our patients, reinsertion of autoclaved femoral and tibial prostheses together with a new same brand polyethylene insert with teicoplanin loaded bone cement can be used cautiously in the management of periprosthetic deep infection of TKA. 2. That is because patients might not want the second stage reimplantation. 3. We believe that the refusal of patients to undergo the surgery shows that the single-stage treatment is effective.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Staphylococcus aureus Resistente à Meticilina , Infecções Relacionadas à Prótese , Idoso , Antibacterianos/uso terapêutico , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Polietileno , Infecções Relacionadas à Prótese/tratamento farmacológico , Reoperação , Reimplante , Estudos Retrospectivos
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