Prevalence and Risk Factors of Reinfection after Two-Stage Exchange Procedure for Treating Periprosthetic Knee Infection
Sukontahong S, MD1, Ruangsomboon P, MD2, Narkbunnam R, MD2, Chareancholvanich K, MD2, Pornrattanamaneewong C, MD2
Affiliation : 1 Department of Orthopaedics, Nakhonpathom Hospital, Nakhonpathom, Thailand 2 Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Two-stage exchange procedure has been considered as the gold standard treatment of chronic periprosthetic joint
infection (PJI) after total knee arthroplasty. However, reinfection still occurs.
Objective : The present study aimed to identify prevalence and risk factor of reinfection after two-stage exchange procedure.
Materials and Methods: Thirty-one patients, who diagnosed chronic PJI and underwent two-stage exchange procedure in our
institute, were retrospectively reviewed with a minimum follow-up of 2 years. Reinfection was recorded and defined as a case. Risk
factors were compared between case and control groups.
Results : Reinfection was found in 4 cases (12.9%). Age, gender, body mass index, history smoking, presence of sinus tract before
the first stage procedure, time between the first and second stage procedure, pre-operative hemoglobin level, operative time, blood
transfusion and types of organism were similar between groups. In univariate analysis, American Society of Anesthesiology
classification in reinfection cases was higher than control group. However, in multivariate analysis, there were no any significant
risk factors in our study.
Conclusion : The present study demonstrates that two-stage exchange procedure has a high success rate with 2-year reinfection
rate of 12.9%.
Keywords : Knee, Infection, Two-stage exchange procedure, Prevalence, Arthroplasty, Risk factors
