Risk Factors for Failure and Reinfection Following One-Stage Revision Total Knee Arthroplasty: A Matched Case-Control...

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Biomaterials Science

Background:

• Evidence on risk factors for one-stage revision failure in periprosthetic joint infection (PJI) is limited.
• This study investigates risk factors for failure in chronic knee PJI after one-stage revision surgery.

Purpose of the Study:

• To characterize patients experiencing failure after one-stage revision for chronic knee PJI.
• To identify independent risk factors associated with failure and reinfection following one-stage revision for knee PJI.

Main Methods:

• Retrospective analysis of 44 patients with failure after one-stage revision for chronic knee PJI.
• A 1:2 matched control group (88 patients) without failure was selected based on age, sex, and revision year.
• Conditional logistic regression was used to identify risk factors for failure and reinfection.

Main Results:

• Most failures (84.1%) occurred within two years post-revision.
• A history of multiple failed surgeries (OR 13.27) and operative time >150 minutes (OR 5.11) were significant risk factors for failure.
• These factors, along with polymicrobial infection (OR 3.16), were also significant risk factors for reinfection.

Conclusions:

• Failures after one-stage revision for knee PJI predominantly occur within the first two postoperative years.
• Multiple prior failed surgeries and prolonged operative times are independent predictors of failure and reinfection.
• Identifying and managing these risk factors is crucial for improving outcomes in patients undergoing one-stage revision for PJI.