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Clinical outcomes of two-stage revision for chronic periprosthetic joint infection of the knee: culture-negative versus culture-positive

박대현|이창락|Kim Doo-Yeol|Kim Chang-Wan|Kim Jeong-Woo
대한슬관절학회 (Korean Knee Society)|2021.12|Knee Surgery and Related Research|제33권 |pp. 28-28|DOI 10.1186/s43019-021-00112-4

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DiagnosisTreatment outcomeKneeArthroplastyPeriprosthetic joint infection

초록

The effect of negative culture on the treatment outcomes of chronic periprosthetic joint infection (PJI) is still controversial. The purpose of this study is to evaluate whether the outcomes of two-stage revision in culture-negative chronic PJI differ from those in culture-positive PJI.The patients who received two-stage revisions due to chronic PJI during the period between 2007 and 2017 were retrospectively reviewed. The culture-negative and culture-positive PJI group included 57 cases and 79 cases, respectively. The demographic data, as well as reoperation, mortality, reinfection, and failure rates of each group were evaluated. There was a significant difference in reoperation rate between the two groups for the period from the first-stage surgery to the second-stage revision arthroplasty ( p = 0.045). The reoperation rate of the culture-positive group was 25.3% (20/79) whereas that of the culture-negative group was 10.5% (6/57). Among the 136 PJI cases, 97 cases (71.3%) received reimplantation surgery (culture-negative group, 43 cases; culture-positive group, 54 cases). No significant difference was noted between the culture-negative and culture-positive groups with respect to the number of cases that did not undergo reimplantation surgery and the reoperation, reinfection, mortality, and failure rates after two-stage surgery ( p > 0.05, all parameters). The culture outcome had no significant effect on the outcome of the two-stage revision in patients with chronic PJI. The reoperation rate after first-stage surgery was significantly higher in the culture-positive group, but the overall failure rate did not significantly differ in both the groups. The presence of a negative culture might be a good prognostic factor for chronic PJI.

Abstract

The effect of negative culture on the treatment outcomes of chronic periprosthetic joint infection (PJI) is still controversial. The purpose of this study is to evaluate whether the outcomes of two-stage revision in culture-negative chronic PJI differ from those in culture-positive PJI.The patients who received two-stage revisions due to chronic PJI during the period between 2007 and 2017 were retrospectively reviewed. The culture-negative and culture-positive PJI group included 57 cases and 79 cases, respectively. The demographic data, as well as reoperation, mortality, reinfection, and failure rates of each group were evaluated. There was a significant difference in reoperation rate between the two groups for the period from the first-stage surgery to the second-stage revision arthroplasty ( p = 0.045). The reoperation rate of the culture-positive group was 25.3% (20/79) whereas that of the culture-negative group was 10.5% (6/57). Among the 136 PJI cases, 97 cases (71.3%) received reimplantation surgery (culture-negative group, 43 cases; culture-positive group, 54 cases). No significant difference was noted between the culture-negative and culture-positive groups with respect to the number of cases that did not undergo reimplantation surgery and the reoperation, reinfection, mortality, and failure rates after two-stage surgery ( p > 0.05, all parameters). The culture outcome had no significant effect on the outcome of the two-stage revision in patients with chronic PJI. The reoperation rate after first-stage surgery was significantly higher in the culture-positive group, but the overall failure rate did not significantly differ in both the groups. The presence of a negative culture might be a good prognostic factor for chronic PJI.

참고문헌 (33)

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관련 논문AI추천

Risk factors of uncontrolled periprosthetic knee joint infection after two-stage reimplantation배기철, Choi Byung-Chan, Kim Dong-Wan, Kim Du-Han대한슬관절학회 · Knee Surgery and Related Research2020 · 제32권 A Review of the Literature on Culture­Negative Periprosthetic Joint Infection: Epidemiology, Diagnosis and Treatment강병훈, 김동희, 남대철, 문동규, 윤홍권, 이동영, 이상혁, 조성희, 황선철대한슬관절학회 · Knee Surgery and Related Research2017 · 제29권 제3호Factors affecting range of motion following two-stage revision arthroplasty for chronic periprosthetic knee infectionJung Soo-Hwan, Kim Chang-Wan, Kim Doo-Yeol, Lee Chang-Rack, Young-Chae Seo대한슬관절학회 · Knee Surgery and Related Research2022 · 제34권 Two-Stage Total Knee Arthroplasty for Prosthetic Joint Infection김동희, 황선철, Dong Yeong Lee, Hong Kwon Yoon, Ho Seung Cho, Min Seok Cha, Sang Hyuk Lee, Se Hyun Cho대한슬관절학회 · Knee Surgery and Related Research2015 · 제27권 제2호Periprosthetic Knee Infection: Ten Strategies That WorkClaudio Diaz-Ledezma, Javad Parvizi, Priscilla Ku Cavanaugh대한슬관절학회 · Knee Surgery and Related Research2013 · 제25권 제4호Functional Outcome after Reimplantation in Patients Treated with and without an Antibiotic-Loaded Cement Spacers for Hip Prosthetic Joint InfectionsAndrea Sambri, Azzurra Paolucci, Claudia Rondinella, Lorenzo Morante, Massimiliano De Paolis, Michele Fiore대한고관절학회 · Hip and Pelvis2023 · 제35권 제1호

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