Two-stage revision of septic knee prosthesis with articulating knee spacers yields better infection eradication rate than one-stage or two-stage revision with static spacers
Articolo
Data di Pubblicazione:
2012
Citazione:
Two-stage revision of septic knee prosthesis with articulating knee spacers yields better infection eradication rate than one-stage or two-stage revision with static spacers / C.L. Romanò, L. Gala, N. Logoluso, D. Romanò, L. Drago. - In: KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY. - ISSN 0942-2056. - 20:12(2012 Dec), pp. 2445-2453.
Abstract:
The best method for treating chronic periprosthetic knee infection
remains controversial. Randomized, comparative studies on treatment modalities are lacking. This systematic review of the literature compares the infection eradication rate after two-stage versus one-stage revision and static versus articulating spacers in two-stage procedures.
METHODS: We reviewed full-text papers and those with an abstract in English published from 1966 through 2011
that reported the success rate of infection eradication after one-stage or
two-stage revision with two different types of spacers.
RESULTS: In all, 6 original articles reporting the results after one-stage knee exchange arthoplasty (n = 204) and 38 papers reporting on two-stage revision (n = 1,421) were reviewed. The average success rate in the eradication of infection was 89.8% after a two-stage revision and 81.9% after a one-stage procedure at a mean follow-up of 44.7 and 40.7 months, respectively. The average infection eradication rate after a two-stage procedure was slightly, although significantly, higher when an articulating spacer rather than a static spacer was
used (91.2 versus 87%).
CONCLUSIONS: The methodological limitations of this study
and the heterogeneous material in the studies reviewed notwithstanding, this
systematic review shows that, on average, a two-stage procedure is associated with a higher rate of eradication of infection than one-stage revision for septic knee prosthesis and that articulating spacers are associated with a lower recurrence of infection than static spacers at a comparable mean duration of
follow-up. LEVEL OF EVIDENCE: IV.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Infection; Knee; One-stage; Revision; Spacer; Total knee replacement; Two-stage
Elenco autori:
C.L. Romanò, L. Gala, N. Logoluso, D. Romanò, L. Drago
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