Irrigation and d bridement is an attractive low morbidity solution for acute periprosthetic knee infection. However, the failure rate in the literature is high, averaging 68% (range, 61%-82%). Patients who fail subsequently undergo two-stage reimplantation after a prolonged period of illness. This leads to higher surgical risk and further delays in rehabilitation and may contribute to failure of subsequent revision surgery.
We determined the rerevision rate due to infection after two-stage reimplantation performed for failed irrigation and d bridement of infected TKA.
Of the 83 knees that had undergone previous irrigation and d bridement, 28 (34%) failed subsequent two-stage revision and required reoperation for persistent infection.
The failure rate in this series of two-stage revisions for periprosthetic knee infection in patients treated with previous irrigation and d bridement is considerably higher than previously reported failure rates of two-stage revision. Factors affecting the failure rate may include host quality, thoroughness of d bridement, and organism virulence. Patients and surgeons must understand that irrigation and d bridement, while initially attractive, may lead to high failure rates of subsequent two-stage reimplantation.
Level of evidence: Level III, therapeutic study. See the guidelines online for a complete description of level of evidence. Copyright remains with the authors and publisher.
Irrigation and d bridement is an attractive low morbidity solution for acute periprosthetic knee infection. However, the failure rate in the literature is high, averaging 68% (range, 61%-82%). Patients who fail subsequently undergo two-stage reimplantation after a prolonged period of illness. This leads to higher surgical risk and further delays in rehabilitation and may contribute to failure of subsequent revision surgery.
We determined the rerevision rate due to infection after two-stage reimplantation performed for failed irrigation and d bridement of infected TKA.
Of the 83 knees that had undergone previous irrigation and d bridement, 28 (34%) failed subsequent two-stage revision and required reoperation for persistent infection.
The failure rate in this series of two-stage revisions for periprosthetic knee infection in patients treated with previous irrigation and d bridement is considerably higher than previously reported failure rates of two-stage revision. Factors affecting the failure rate may include host quality, thoroughness of d bridement, and organism virulence. Patients and surgeons must understand that irrigation and d bridement, while initially attractive, may lead to high failure rates of subsequent two-stage reimplantation.
Level of evidence: Level III, therapeutic study. See the guidelines online for a complete description of level of evidence. Copyright remains with the authors and publisher.