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Periprosthetic knee infections treated with irrigation and debridement: outcomes and preoperative predictive factors
Georgios K Triantafyllopoulos1, Lazaros A Poultsides1, Wei Zhang2
1Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
Abstract:
The role of irrigation and debridement (I&D) in the treatment of periprosthetic joint infections (PJI) of the knee remains controversial. Our purpose was to identify the success rate and factors determining outcome of I&D in those patients. Clinical characteristics of 78 patients with PJI of the knee treated with I&D were retrospectively reviewed. Implant retention at final follow-up was achieved in 43 patients (55.1%). Logistic regression analysis revealed that duration of symptoms >5days and thyroid disease were independent predictors of I&D failure. Patients with methicillin-resistant staphylococcal infections had a success rate of 45.5% and significantly lower odds of success compared to patients with negative cultures. In selected patients, I&D is a reasonable option in the context of acute PJI of the knee.
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