Published in:
01-10-2015 | Knee Arthroplasty
The outcome of infected total knee arthroplasty: culture-positive versus culture-negative
Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2015
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Purpose
We studied the outcome in culture-positive and culture-negative infected total knee arthroplasty (TKA).
Methods
We retrospectively reviewed 140 patients with culture-positive and 102 patients with culture-negative infected TKAs. We determined the infection control rate and clinical outcome after repeated debridement, and repeated 2-stage TKA in the culture-positive and culture-negative groups. The mean follow-up was 9.3 years (range 5–14 years) in the culture-positive group and 10.6 years (5–22) in the culture-negative group.
Results
The overall infection control rate was 56 % in both groups after the first treatment. The overall infection control rate was 90 % in the culture-positive group and 95 % in the culture-negative group. A functional knee was obtained in 90 % in the culture-positive group and 95 % in the culture-negative group.
Conclusions
The data suggest that treatment according to the types of infection in both culture-positive and culture-negative groups after TKA controlled infection and maintained functional TKA with a firm level of fixation for most patients. Repeated debridement and repeated two-stage exchange TKA further improved infection control rates after the initial treatment and increased the likelihood of maintaining a functional TKA.