One-stage And Two-stage Revision Operations Treat Infection After Total Knee Arthroplasty

Objective To explore one-stage and two-stage revision treat the infection after total knee arthroplasty, as well as compare the curative effect.Methods From January2006to January2013,46cases of infection after TKA was treated, including24males and22females, with a mean age of65.9years(57-79years). All of the patients have knee pain and dysfunction,13patients with sinus; abnormal ESR and CRP was infected in46patients.The X-ray films showed that periosteal reaction, osteolysis and loosening of prosthesis oeeurred. The results of bacterial culture were positive in46cases. One-stage revision was performed21cases, while two-stage revision was performed25cases.Results The microorganism cultures results of secrata of sinus preoperatively and intraoperative tissue were positive in46cases;25had staphyloeoecus epidermids infection, and12staphylocoeeus aureus infection.Postoperative recurrent infection was found in6cases with the mean follow-up of54.3months. The mean AKS score inereased significantly to89(15-93) after revision, showing significant difference when compared with that before operation(P<0.01). The clearance rate of infective issue in one-stage is78.3%, two-stage is97.5%.Conclusion Both one-stage and two-stage revision can control the infection, but the infection clearance of two-stage is better than one-stage revision. The main microorganism of postoperative in fection after TKA is staphytoeoeeus epidermids and staphyloeoecus aureus.Infection after TKA should be prevention rather than cure.