One-stage versus two-stage prosthesis replacement for prosthetic knee infections

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management
• Biomedical Engineering

Background:

• Periprosthetic knee infection is a serious complication following knee replacement surgery.
• Lack of clear criteria complicates the choice between one-stage and two-stage revision surgeries.
• One-stage replacement may offer advantages in infection control and functional recovery.

Purpose of the Study:

• To compare infection outcomes between one-stage and two-stage knee replacement procedures.
• To evaluate and compare functional results, including range of motion and patient-reported scores, after both procedures.
• To assess the efficacy of one-stage versus two-stage revision arthroplasty for infected knee prostheses.

Main Methods:

• Retrospective study analyzing data from January 2009 to December 2014.
• Comparison of infection cure rates and functional outcomes (IKS, KOOS, SF-12 scores) between one-stage and two-stage revision groups.
• Involved 41 patients in the two-stage group and 21 in the one-stage group, with an average follow-up of 22 months.

Main Results:

• Infection cure rates were 78% for two-stage and 90% for one-stage replacement (P=0.3).
• Significantly better flexion range of motion was observed in the one-stage group (P=0.04).
• Improved IKS and KOOS scores were noted in the one-stage group, with no difference in SF-12 scores.

Conclusions:

• One-stage knee replacement demonstrates comparable infection healing rates to two-stage procedures.
• The one-stage approach is associated with superior functional outcomes, including better knee function and range of motion.
• One-stage revision arthroplasty is a promising alternative for managing periprosthetic knee infections.