Outcomes of Modular Knee Arthrodesis for Challenging Periprosthetic Joint Infections

Alexandra I. Stavrakis, MD; Erik N. Mayer, MD; Sai K. Devana, MD; Madhav Chowdhry, MD; Matthew V. Dipane, BS; Edward J. McPherson, MD

Arthroplasty Today (Feb 2022)

Outcomes of Modular Knee Arthrodesis for Challenging Periprosthetic Joint Infections

Alexandra I. Stavrakis, MD,
Erik N. Mayer, MD,
Sai K. Devana, MD,
Madhav Chowdhry, MD,
Matthew V. Dipane, BS,
Edward J. McPherson, MD

Affiliations

Alexandra I. Stavrakis, MD: Corresponding author. Department of Orthopaedic Surgery, University of California Los Angeles, 1250 16th St Suite 2100, 90404, Santa Monica, CA 90404, USA. Tel.: +1 424 259 9892.; Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USA
Erik N. Mayer, MD: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USA
Sai K. Devana, MD: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USA
Madhav Chowdhry, MD: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USA
Matthew V. Dipane, BS: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USA
Edward J. McPherson, MD: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USA

Journal volume & issue: Vol. 13
pp. 199 – 204

Abstract

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Background: Modular knee arthrodesis (MKA) is a salvage treatment option for patients with challenging periprosthetic joint infections (PJI). The purpose of this study was to investigate the outcomes of patients who underwent MKA for PJI with a single technique and determine if specific factors are associated with MKA failure. Methods: This was a retrospective review of 81 patients who underwent MKA at a single institution. Knee Society Scores were recorded before MKA and at the final follow-up (mean 52 months). Poisson regression was used to calculate rate ratios for MKA failure secondary to infection. Results: The mean patient age was 67 years; most patients were McPherson B hosts (56.8%) and had type 3 extremities (53.1%), and all had a type III infection (chronic, >4 wks). Forty-six percent of patients had a prior explantation (59.5% failed 2-stage, 40.5% failed spacer). Staphylococcus epidermidis and Staphylococcus aureus were the most common organisms, 22.2% and 18.5%, respectively. Thirty percent of patients had at least one reoperation, excluding reimplantation (14.8% irrigation and debridement/wound closure, 9.9% MKA exchange, and 7.4% amputation). Of 82.7% of MKA patients with no evidence of infection, 82.1% (56 patients) underwent reimplantation endoprosthetic reconstruction, and 67.3% of these remained infection-free at the final follow-up. Discussion: MKA is a salvage option for challenging PJI cases that may serve as definitive surgical management or as a bridge to endoprosthetic reconstruction for patients who have failed prior infection control procedures.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

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