Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Infections
Abstract number: 26535
INFECTED TOTAL KNEE ARTHROPLASTY - 10 YEARS OF EXPERIENCE
Zoran POPOVIC, Radoslav BARJAKTAROVIC, Dragan RADOICIC
Military Medical Academy, Clinic for Orthopaedic Surgery and Traumatology,
Belgrade (SERBIA)
Infected total knee arthroplasty (TKA) remains a major topic of interest because of its
diagnostic challenges, requisite intensity of care, and often compromised outcomes.
Infected TKA requires 3 to 4 times the hospital resources when compared with
primary TKA, and double the resources when compared with aseptic revision TKA. In
the period 1998 to 2008. in M M A - Orthopaedics & Traumatology Clinic, 654 TKAs
was performed. During this period we have registered and surgicaly treated 28
infected TKAs (MMAs primary TKAs - 22, other institutions primary TKAs - 6). MMA
incidence of TKA infection was 3,36%. The most common were: Staphylococcus
Aureus 14 cases - 50%, Staph. Epidermidis - 3 cases - 10,7%. Other isolated
pathogens were: Enterococcus faecalis, Klebsiela pneum., Klebsiela spec.,
Streptoccocus viridans, Seratia species, Micrococcus luteus and Peptostreptococcus
spec. In one case we had mixed anaerobic flora, and in 3 cases cultures were
negative.In our series 4 patients responded fully to one stage reimplantation, 12
cases responded fully to two stage reimplantation, 11 patients ended with arthrodesis
(9 ex.fix., 2 plating technique) and we had 1 above knee amputation.Two stage
revision remains “golden standard” in infected TKA and is treatment of choice in
Military Medical Academy. Eradication of infection is a necessary condition for
success of reimplantation. AB-spacer prothesis concept preserves function, higher
patient’s satisfaction, infects eradication and provides excellent cost/effectiveness.
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