Clinical outcomes of two-stage revision for chronic periprosthetic joint infection of the knee: culture-negative versus culture-positive.

IF 4.1 Q1 ORTHOPEDICS
Chang-Wan Kim, Chang-Rack Lee, Dae-Hyun Park, Doo-Yeol Kim, Jeong-Woo Kim
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引用次数: 8

Abstract

Background: The effect of negative culture on the treatment outcomes of chronic periprosthetic joint infection (PJI) is still controversial. The purpose of this study is to evaluate whether the outcomes of two-stage revision in culture-negative chronic PJI differ from those in culture-positive PJI.

Methods: The patients who received two-stage revisions due to chronic PJI during the period between 2007 and 2017 were retrospectively reviewed. The culture-negative and culture-positive PJI group included 57 cases and 79 cases, respectively. The demographic data, as well as reoperation, mortality, reinfection, and failure rates of each group were evaluated.

Results: There was a significant difference in reoperation rate between the two groups for the period from the first-stage surgery to the second-stage revision arthroplasty (p = 0.045). The reoperation rate of the culture-positive group was 25.3% (20/79) whereas that of the culture-negative group was 10.5% (6/57). Among the 136 PJI cases, 97 cases (71.3%) received reimplantation surgery (culture-negative group, 43 cases; culture-positive group, 54 cases). No significant difference was noted between the culture-negative and culture-positive groups with respect to the number of cases that did not undergo reimplantation surgery and the reoperation, reinfection, mortality, and failure rates after two-stage surgery (p > 0.05, all parameters).

Conclusions: The culture outcome had no significant effect on the outcome of the two-stage revision in patients with chronic PJI. The reoperation rate after first-stage surgery was significantly higher in the culture-positive group, but the overall failure rate did not significantly differ in both the groups. The presence of a negative culture might be a good prognostic factor for chronic PJI.

Abstract Image

慢性膝关节假体周围关节感染的两阶段翻修的临床结果:培养阴性vs培养阳性。
背景:阴性培养对慢性假体周围关节感染(PJI)治疗效果的影响仍有争议。本研究的目的是评估培养阴性的慢性PJI两阶段修复的结果是否与培养阳性的PJI不同。方法:回顾性分析2007年至2017年期间因慢性PJI接受两期翻修的患者。PJI培养阴性组57例,培养阳性组79例。评估两组患者的人口学资料,再手术率、死亡率、再感染率和失败率。结果:两组患者一期手术至二期翻修关节置换术期间再手术率差异有统计学意义(p = 0.045)。培养阳性组再手术率为25.3%(20/79),阴性组再手术率为10.5%(6/57)。136例PJI患者中,97例(71.3%)行再植手术(培养阴性组43例;培养阳性组54例)。培养阴性组与培养阳性组未行再植手术例数及两期手术后的再手术、再感染、死亡率、失败率比较,差异均无统计学意义(p > 0.05)。结论:培养结果对慢性PJI患者两期翻修的结果无显著影响。培养阳性组一期手术后再手术率明显高于对照组,但两组总失败率无显著差异。阴性培养的存在可能是慢性PJI的一个良好预后因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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