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BMC Musculoskeletal Disorders

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Open Access 01-12-2013 | Research article

A systematic review of the evidence for single stage and two stage revision of infected knee replacement

Authors: James PM Masters, Nicholas A Smith, Pedro Foguet, Mike Reed, Helen Parsons, Andrew P Sprowson

Published in: BMC Musculoskeletal Disorders | Issue 1/2013

Abstract

Background

Periprosthetic infection about the knee is a devastating complication that may affect between 1% and 5% of knee replacement. With over 79 000 knee replacements being implanted each year in the UK, periprosthetic infection (PJI) is set to become an important burden of disease and cost to the healthcare economy. One of the important controversies in treatment of PJI is whether a single stage revision operation is superior to a two-stage procedure. This study sought to systematically evaluate the published evidence to determine which technique had lowest reinfection rates.

Methods

A systematic review of the literature was undertaken using the MEDLINE and EMBASE databases with the aim to identify existing studies that present the outcomes of each surgical technique. Reinfection rate was the primary outcome measure. Studies of specific subsets of patients such as resistant organisms were excluded.

Results

63 studies were identified that met the inclusion criteria. The majority of which (58) were reports of two-stage revision. Reinfection rated varied between 0% and 41% in two-stage studies, and 0% and 11% in single stage studies. No clinical trials were identified and the majority of studies were observational studies.

Conclusions

Evidence for both one-stage and two-stage revision is largely of low quality. The evidence basis for two-stage revision is significantly larger, and further work into direct comparison between the two techniques should be undertaken as a priority.

Available only for authorised users

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2474/14/222/prepub

Title: A systematic review of the evidence for single stage and two stage revision of infected knee replacement
Authors: James PM Masters
Nicholas A Smith
Pedro Foguet
Mike Reed
Helen Parsons
Andrew P Sprowson
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2013
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/1471-2474-14-222

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A systematic review of the evidence for single stage and two stage revision of infected knee replacement

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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