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Ribes C, Masquefa T, Dutronc H, De Seynes C, Dupon M, Fabre T, Dauchy FA. One-stage versus two-stage prosthesis replacement for prosthetic knee infections. Med Mal Infect 2019; 49:519-526. [PMID: 30795868 DOI: 10.1016/j.medmal.2019.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/27/2018] [Accepted: 01/28/2019] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Periprosthetic knee infection is a severe complication. Confirmed criteria are lacking to choose between one-stage or two-stage prosthesis replacement to treat the infection. The one-stage replacement could lead to a satisfactory control of the infection and to better functional results. METHOD Retrospective study conducted between January 1, 2009 and December 31, 2014. The objectives of this study were to compare the infection outcome and functional results between the one-stage and two-stage replacement procedures. Functional results were evaluated using the IKS score, KOOS score, and SF-12 quality of life score. RESULTS Forty-one patients underwent a two-stage replacement procedure and 21 patients a one-stage replacement. The average follow-up was 22 months after surgery. The infection was cured in 78% of patients who underwent a two-stage replacement and 90% of patients who underwent a one-stage replacement (P=0.3). The flexion range of motion was significantly better in the one-stage group than in the two-stage group (P=0.04). Results of the IKS score and of the KOOS score were better in the one-stage group. No difference was observed for the SF-12 score. CONCLUSION The one-stage replacement procedure for periprosthetic knee infection was associated with a similar healing frequency as the two-stage replacement procedure, and with better knee function.
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Affiliation(s)
- C Ribes
- Unité de chirurgie orthopédique périphérique, hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France.
| | - T Masquefa
- Unité de chirurgie orthopédique périphérique, hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France
| | - H Dutronc
- Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France
| | - C De Seynes
- Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Maison de santé protestante de Bordeaux Bagatelle, 33401 Bordeaux, France
| | - M Dupon
- Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France
| | - T Fabre
- Unité de chirurgie orthopédique périphérique, hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France
| | - F A Dauchy
- Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France
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