2-STAGE REIMPLANTATION FOR INFECTED TOTAL KNEE REPLACEMENT

Between 1977 and 1983, 64 infected total knee replacements in 60 patie nts were treated with a 2-stage protocol for reimplantation, The clini cal results and survivorship were determined at an average followup of 7.5 years (range, 2-17 years). Surgical protocol included removal of the prosthesis and all cement with thorough debridement of bone and so ft tissues, This was followed by 6 weeks of parenteral antibiotics and then reimplantation of a new prosthesis, At followup, 6 knees (9%) ha d become reinfected, but only 2 with the same organism, Four knees had been revised: 3 for aseptic loosening and 1 for a periprosthetic femu r fracture. Two other knees were impending failures due to aseptic loo sening, The average Hospital for Special Surgery knee score was 78 poi nts with 18 excellent, 28 good, 13 fair, and 5 poor results, Seventy-e ight percent of patients were satisfied with the overall result of the ir reimplanted prosthesis and 95% think that they made the right decis ion in undergoing total knee arthroplasty, The 10-year predicted survi vorship of 2-stage reimplantation is 77.4%. Two-stage reimplantation w ith a 6-week course of parenteral antibiotics is an effective means to eradicate deep infection and to provide a functional knee, The long t erm functional results and overall survivorship are comparable with th e results of revision of aseptic failed total knee arthroplasty.