TREATMENT OF THE INFECTED TOTAL KNEE ARTHROPLASTY WITH INSERTION OF ANOTHER PROSTHESIS - THE EFFECT OF ANTIBIOTIC-IMPREGNATED BONE-CEMENT

Eighty-six patients with 89 infected total knee arthroplasties were tr eated with insertion of another prosthesis. Treatment was not accordin g to an established protocol for parameters, such as delay between rem oval of the infected prosthesis and insertion of the new prosthesis, d uration of antibiotics, use of antibiotic-impregnated cement spacers o r beads, and use of antibiotic-impregnated cement for prosthetic fixat ion at revision surgery. Final followup averaged 52 months (range, 6-1 26 months). Complications occurred in 30 (33.7%) knees, with recurrent deep infection developing in 10 (11.24%) knees. Patient age, medical diagnosis, type of microorganism, duration of parenteral antibiotics, delay between the resection and revision surgery, and use of antibioti c-impregnated cement spacers or beads were not correlated with the cur e rate of infection. Use of antibiotic-impregnated bone cement for pro sthesis fixation at revision surgery was the only variable that correl ated with the cure rate of deep infection. Seven (28%) of the 25 knees without antibiotic-impregnated cement for prosthesis fixation develop ed recurrent infection compared with 3 (4.7%) of 64 knees with antibio tic-impregnated cement for prosthesis fixation. This difference was st atistically significant (p = 0.0025, log-rank test).