Early and Mid-Term Results of Two Stage Revision Arthroplasty in Infected Total Knee Arthroplasty Cases

Abstract

Abstract Background: Total knee arthroplasty is a treatment method to relieve pain and limitation of movement caused by many knee diseases such as degenerative arthritis. Our aim was to retrospectively evaluate the early and mid-term results of patients with infected total knee arthroplasty who underwent two-stage revision as a treatment method and to compare them with the literature. Methods: Patients who were diagnosed with infected knee prosthesis in the Orthopaedics and Traumatology clinic of our hospital between January 2004 and 2014 and decided to undergo two-stage revision as a treatment method were included in this study. Laboratory results, radiographs, American Knee Society clinical and functional scores were evaluated. Results: Twenty knees of 19 patients were included in the study. The first stage of two-stage revision was performed in all patients and the second stage was performed in 17 patients. Of the 20 knees diagnosed with infected total knee arthroplasty, 3 had early, 6 had delayed, and 11 had late infection. Preoperative clinical score was 53.29 ± 9.51, postoperative 83.21 ± 9.51 (p<0.001); functional score was 40.88 (SD 20.48) preoperatively and 63.23 ± 30.81 (p=0.018) postoperatively. The mean degree of flexion was 68.52° ±19.34 preoperatively and 92.64° ±16.30 after revision (p<0.001). Compared to the pre-revision period, pain levels of all our patients decreased and walking distances increased. Conclusion: Two-stage revision surgery in infected total knee prostheses was found to be compatible with the literature in terms of eradication of infection, postoperative clinical and functional scores.

Keywords

• iki aşamalı revizyon
• diz protezi
• protez enfeksiyonu

Enfekte Total Diz Artroplastisi Olgularında İki Aşamalı Revizyon Artroplastisinin Erken ve Orta Dönem Sonuçları

Öz

Amaç: Total diz artroplastisi, dejeneratif artrit gibi birçok diz hastalığının sebep olduğu ağrı ve hareket kısıtlılığını gidermek amacıyla uygulanan bir tedavi yöntemidir. Amacımız enfekte total diz artroplastisi tanılı hastalara tedavi yöntemi olarak iki aşamalı revizyon yapılanların erken ve orta dönem sonuçlarının retrospektif olarak değerlendirilmesi ve literatürle karşılaştırılmasıdır. Gereç ve Yöntem: Bu çalışmaya Ocak 2004–2014 tarihleri arasında hastanemiz Ortopedi ve Travmatoloji kliniğinde enfekte diz protezi tanısı alan ve tedavi yöntemi olarak iki aşamalı revizyona karar verilen hastalar alındı. Hastaların laboratuvar sonuçları, radyografileri, Amerikan diz cemiyeti klinik ve fonksiyonel skorları değerlendirildi. Bulgular: Çalışmaya 19 hastanın 20 dizi alınmıştır. Tüm hastalara iki aşamalı revizyonun birinci aşama ameliyatı yapılmış, ikinci aşama ameliyat ise 17 hastaya yapılmıştır. Enfekte total diz protezi tanısı almış 20 dizden; 3’ünde erken, 6’sında gecikmiş, 11’inde ise geç enfeksiyon tespit edilmiştir. Preoperatif klinik skor 53,29 ± 9,51 iken postoperatif 83,21 ± 9,51 (p<0,001); fonksiyonel skor ise preoperatif değer 40,88 (Sd 20,48) iken, postoperatif değer 63,23 ± 30,81 (p=0,018) olarak saptandı. Ortalama fleksiyon derecesi preoperatif ortalama 68,52° ±19,34 iken revizyon sonrası 92,64° ±16,30 çıkmıştır (p<0,001). Revizyon öncesi döneme göre tüm hastalarımızın ağrı düzeyleri azalmış ve yürüme mesafeleri artmıştır. Sonuç: Enfekte total diz protezlerinde iki aşamalı revizyon cerrahisi; enfeksiyonu eradike etmede, postoperatif klinik ve fonksiyonel skorlar olarak literatürle uyumlu bulunmuştur.

Anahtar Kelimeler

• protez enfeksiyonu
• iki aşamalı revizyon
• artroplasti

Kaynakça

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