Qiao YJ, Li F, Zhang LD, Yu XY, Zhang HQ, Yang WB, Song XY, Xu RL, Zhou SH. Analysis of the clinical efficacy of two-stage revision surgery in the treatment of periprosthetic joint infection in the knee: A retrospective study. World J Clin Cases 2022; 10(36): 13239-13249 [PMID: 36683646 DOI: 10.12998/wjcc.v10.i36.13239]
Corresponding Author of This Article
Sheng-Hu Zhou, PhD, Doctor, Department of Joint Surgery, The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, No. 333 Nanbinghe Road, Qilihe District, Lanzhou 730050, Gansu Province, China. zhoushenghu120@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yong-Jie Qiao, Xin-Yuan Yu, Hao-Qiang Zhang, Wen-Bin Yang, Xiao-Yang Song, Rui-Ling Xu, Sheng-Hu Zhou, Department of Joint Surgery, The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Lanzhou 730050, Gansu Province, China
Feng Li, Department of Orthopedics, The 943rd Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Wuwei 733000, Gansu Province, China
Lv-Dan Zhang, Department of Respiratory Medicine, The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Lanzhou 730050, Gansu Province, China
Author contributions: Qiao YJ, Li F and Zhang LD contributed equally to this work; Qiao YJ, Li F and Zhang LD designed the study, collected data, performed the statistical analysis, and wrote the manuscript; Zhang HQ and Yu XY assisted with data collection; Yang WB drafted the manuscript; Zhang HQ and Song XY helped with data interpretation and critically reviewed the manuscript; Zhou SH conceived of the study, helped with data interpretation, and critically reviewed the manuscript; All the authors read and approved the final manuscript.
Institutional review board statement: Formal institutional approval was not deemed necessary since anonymised data routinely collected in our centre for clinical practice purposes were used.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sheng-Hu Zhou, PhD, Doctor, Department of Joint Surgery, The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, No. 333 Nanbinghe Road, Qilihe District, Lanzhou 730050, Gansu Province, China. zhoushenghu120@163.com
Received: August 10, 2022 Peer-review started: August 10, 2022 First decision: November 11, 2022 Revised: November 15, 2022 Accepted: December 5, 2022 Article in press: December 5, 2022 Published online: December 26, 2022 Processing time: 138 Days and 10.7 Hours
ARTICLE HIGHLIGHTS
Research background
Periprosthetic joint infection (PJI) is a catastrophic complication after total knee arthroplasty (TKA).
Research motivation
This study aimed to retrospectively analyze 27 patients with PJI who were treated with one-stage debridement, implant removal, antibiotic bone cement spacer exclusion, and two-stage revision and compare their preoperative and follow-up results.
Research objectives
This study aimed to explore the clinical effect of one-stage debridement, implant removal, antibiotic bone cement spacer exclusion, and two-stage revision in the treatment of PJI after TKA.
Research methods
Of 27 patients with PJI treated with two-stage revision surgery were analyzed retrospectively. The following outcomes were compared for changes between preoperative and last follow-up results: Erythrocyte sedimentation rate, C-reactive protein, visual analogue scale scores, Hospital for Special Surgery scores, knee range of motion, and infection cure rates.
Research results
Of the 27 patients, 26 were cured of the infection, whereas 1 case had an infection recurrence; the infection control rate was 96.3%.
Research conclusions
Two-stage revision surgery can effectively relieve pain, control infection, and retain good joint function in the treatment of PJI after TKA.
Research perspectives
Whether the PJI can be cured using the one-stage debridement, implant removal, antibiotic bone cement spacer exclusion, and two-stage revision.
