[Treatment modalities in infected knee alloarthroplasties]

The purpose of this study was to present and to evaluate different treatment options in the infected knee alloarthroplasty.

We followed 47 infected knee alloarthroplasties with a mean follow-up of 62 months which were surgically treated by different techniques. There were 20 cases with early infection (< or = 12 months) and 27 cases with late infections (> 12 months).

In 10 patients a two stage exchange of the implant were undertaken. In 6 of those 10 cases the infection could be successfully treated. 30 patients underwent an arthrodesis, two of those after an unsuccessful exchange procedure. In this group only in two patients the infection was not managed successfully. 28 of the patients with an arthrodesis showed a good result of the fusion side. One case was only debrided and in 8 cases bony and soft tissue damage lead to amputation. The HSS-score showed an excellent results in 5.3%, a good result in 21%, a fair result in 26.3% and a poor results in 47.4% of the cases. Comparable distribution was documented with the Hungerford-score. Patients with a stable and painless fusion showed a comparable functional outcome to those patients with a new replacement.

Revision of an infected knee implant is best managed by a two stage procedure and can lead to a good functional result. Fusion is indicated in cases with bad bony and soft tissue situation. A solid arthrodesis gives a painfree and stable extremity.