RESULTS OF 2-STAGE REIMPLANTATION FOR INFECTED TOTAL KNEE ARTHROPLASTY

Optimum treatment of the infected total knee arthroplasty has not been clearly established. To clarify the efficacy of two-stage reimplantat ion, experience with 66 infected total knee arthroplasties in 64 patie nts who had been treated with 2-stage reimplantation total knee arthro plasty between September 1980 and October 1993 was reviewed. Of these, 55 knees in 54 patients were available for follow-up examinations at an average of 61.9 months (range, 28-146 months). The initial diagnose s were rheumatoid arthritis (14 knees) and osteoarthritis (41 knees). Reimplantation was successful in 80.0% of knees with low-virulence org anisms (coagulase-negative Staphylococcus, Streptococcus), 71.4% with polymicrobial organ isms, and 66.7% with high-virulence organisms (met hicillin-resistant Staphylococcus aureus). Reimplantation was successf ul in 82% of patients with osteoarthritis and in 54% of patients with rheumatoid arthritis (P = .024). The success rate was 92% if infection occurred after primary arthroplasty but only 41% if after multiple pr evious knee operations (arthroscopy, osteotomy, or revision total knee arthroplasty) (P < .001).