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Volume 3, Issue 4 (Suppl) J Clin Exp Orthop
ISSN:2471-8416 Osteoporosis and Arthroplasty 2017
December 04-05, 2017
&
11th International Conference on
Joint Event
OSTEOPOROSIS, ARTHRITIS & MUSCULOSKELETAL DISORDERS
December 04-05, 2017 | Madrid, Spain
10th INTERNATIONAL CONFERENCE ON ARTHROPLASTY
Infected total knee replacement: Outcomes of alternative management options
Mohammed A Almustafa, Simon Barton and David S Johnson
Stockport NHS Foundation Trust, UK
Background: Prosthetic joint infection (PJI) is a catastrophic complication following knee arthroplasty. Appropriate diagnosis and
management are crucial to maintain a patient’s function and reduce morbidity.
Aim: Assess the outcome of three management strategies: revision of implant (1 or 2 stage); debridement and implant retention
(DAIR); long-term suppressive therapy (including initial aspiration/washout).
Methods: 72 patients were identified as having a PJI within a knee replacement presenting to a single centre between January 2000
and October 2014. Case records were reviewed to assess management and outcome of treatment, including success determined by
avoidance of further surgery/relapse.
Results: Two patients underwent only the first of a two-stage revision; one ankylosed without symptoms; one declined the second
stage due to satisfactory function with a cement spacer still functioning well at four years.
Conclusion: Revision (1 or 2 stage) of all implants remains the gold standard of care for PJI following knee replacement. Long-term
suppressive therapy provided acceptable rates of infection control in patients unfit for revision surgery and was more effective than
DAIR in our cohort. Patients unfit for surgical management of their PJI have an extremely high one-year mortality rate.
Implications: Suppressive therapy is an acceptable treatment strategy for the surgical unfit patient with PJI of a knee replacement.
Recent Publications
1. N C Sciberras, M Almustafa, B R K Smith, A H Deakin, D J Allen and F Picard (2016) A randomized controlled trial to
compare component placement in navigated total knee arthroplasty using original and streamlined registration processes.
Arthroplasty Today 3(2):111-117
2. A M Ewen, M Almustafa, J V Clarke and F Picard (2015) Infection rate and risk factors following primary total hip
arthroplasty. The Bone and Joint Journal 97-B (SUPP 12) 50.
3. M Almustafa, A M Ewen, A H Deakin and F Picard. Risk Factors and Infection Rates Following Total Knee Replacement at
the Golden Jubilee National Hospital 2009 – 2010.
Biography
Mohammed AAlmustafa has his expertise evaluation in Orthopedics and Trauma Surgery. He had his training in Trauma and Orthopaedics in the East of England
Deanery. Presently, he is working at the Department of Trauma and Orthopedics, Stockport NHS Foundation Trust, Stockport.
Mohammed A Almustafa et al., J Clin Exp Orthop 2017, 3:4(Suppl)
DOI: 10.4172/2471-8416-C1-002