Treatment modalities in infected knee alloarthroplasties

Purpose: The purpose of this study was to present and to evaluate different treatment options in the infected knee alloarthroplasty. Methods: We followed 47 infected knee alloarthroplasties with a mean follow -up of 62 months which were surgically treated by different techniques. The re were 20 cases with early infection (less than or equal to 12 months) and 27 cases with late infections (>12 months). Results: In 10 patients a two stage exchange of the implant were undertaken . In 6 of those 10 cases the infection could be successfully treated. 30 pa tients underwent an arthrodesis, two of those after an unsuccessful exchang e procedure. In this group only in two patients the infection was not manag ed successfully. 28 of the patients with an arthrodesis showed a good resul t of the fusion side. One case was only debrided and in 8 cases bony and so ft tissue damage lead to amputation. The HSS-score showed an excellent resu lts in 5.3%, a good result in 21%, a fair result in 26.3% and a poor result s in 47.4% of the cases. Comparable distribution was documented with the Hu ngerford-score, Patients with a stable and painless fusion showed a compara ble functional outcome to those patients with a new replacement. Conclusion: Revision of an infected knee implant is best managed by a two s tage procedure and can lead to a good functional result. Fusion is indicate d in cases with bad bony and soft tissue situation. A solid arthrodesis giv es a painfree and stable extremity.