Prevalence and risk factors of reinfection after two-stage exchange procedure for treating periprosthetic knee infection

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND| 2019 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%.