Related Experiment Video
Updated: May 1, 2026
Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
Published on: February 2, 2024
Single-stage revision for fungal peri-prosthetic joint infection: a single-centre experience
T O Klatte1, D Kendoff, A F Kamath
1University Medical Center Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Germany.
Abstract:
Fungal peri-prosthetic infections of the knee and hip are rare but likely to result in devastating complications. In this study we evaluated the results of their management using a single-stage exchange technique. Between 2001 and 2011, 14 patients (ten hips, four knees) were treated for a peri-prosthetic fungal infection. One patient was excluded because revision surgery was not possible owing to a large acetabular defect. One patient developed a further infection two months post-operatively and was excluded from the analysis. Two patients died of unrelated causes. After a mean of seven years (3 to 11) a total of ten patients were available for follow-up. One patient, undergoing revision replacement of the hip, had a post-operative dislocation. Another patient, undergoing revision replacement of the knee, developed a wound infection and required revision 29 months post-operatively following a peri-prosthetic femoral fracture. The mean Harris hip score increased to 74 points (63 to 84; p < 0.02) in those undergoing revision replacement of the hip, and the mean Hospital for Special Surgery knee score increased to 75 points (70 to 80; p < 0.01) in those undergoing revision replacement of the knee. A single-stage revision following fungal peri-prosthetic infection is feasible, with an acceptable rate of a satisfactory outcome.
Insights
Single-stage revision surgery for fungal knee and hip infections is feasible. This approach offers a viable solution for managing these rare but severe prosthetic joint complications, leading to satisfactory outcomes.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Biomedical Engineering
Background:
- Fungal peri-prosthetic infections of the knee and hip are infrequent but lead to severe complications.
- Effective management strategies are crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of a single-stage exchange technique for managing fungal peri-prosthetic joint infections.
- To assess the functional outcomes and complication rates associated with this surgical approach.
Main Methods:
- A retrospective analysis of 14 patients (10 hips, 4 knees) treated between 2001 and 2011 for fungal peri-prosthetic infections.
- Patients underwent a single-stage revision surgery.
- Follow-up was conducted for a mean of seven years.
Main Results:
- Ten patients were available for long-term follow-up.
- Significant improvements were observed in functional scores: mean Harris hip score increased to 74 (p < 0.02) and mean Hospital for Special Surgery knee score to 75 (p < 0.01).
- Complications included one post-operative dislocation and one late wound infection requiring revision.
Conclusions:
- Single-stage revision surgery is a feasible treatment option for fungal peri-prosthetic infections.
- This approach can achieve acceptable functional outcomes despite the challenges posed by these infections.
