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Infection after total knee arthroplasty: The Avon experience

Blom, Ashley W. , Brown, J., Taylor, Adrian H. , Pattison, Giles , Whitehouse, Sarah L., & Bannister, Gordon C. (2004) Infection after total knee arthroplasty: The Avon experience. Journal of Bone and Joint Surgery: British Volume, 86(B), pp. 688-691.

Abstract

The aim of our study was to determine the current incidence and outcome of infected total knee arthroplasty (TKA) in our unit comparing them with our earlier audit in 1986, which had revealed infection rates of 4.4% after 471 primary TKAs and 15% after 23 revision TKAs at a mean follow-up of 2.8 years. In the interim we introduced stringent antibiotic prophylaxis, and the routine use of occlusive clothing within vertical laminar flow theatres and 0.05% chlorhexidine lavage during arthroplasty surgery.

We followed up 931 primary TKAs and 69 revision TKAs for a mean of 6.5 years (5 to 8). Patients were traced by postal questionnaire, telephone interview or examination of case notes of the deceased.

Nine (1%) of the patients who underwent primary TKA, and four (5.8%) of those who underwent revision TKA developed deep infection. Two of nine patients (22.2%) who developed infection after primary TKA were successfully treated without further surgery. All four of the patients who had infection after revision TKA had a poor outcome with one amputation, one chronic discharging sinus and two arthrodeses.

Patients who underwent an arthrodesis had comparable Oxford knee scores to those who underwent a two-stage revision. Although infection rates have declined with the introduction of prophylactic measures, and more patients are undergoing TKA, the outcome of infected TKA has improved very little.

Impact and interest:

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ID Code: 5597
Item Type: Journal Article
Additional Information: For more information, please refer to the journal's website (see link) or contact the author. Author contact details: s.whitehouse@qut.edu.au
Additional URLs:
ISSN: 0301-620X
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Orthopaedics (110314)
Divisions: Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering
Copyright Owner: Copyright 2004 British Editorial Society of Bone and Joint Surgery
Deposited On: 30 Nov 2006
Last Modified: 29 Feb 2012 23:04

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