TY - JOUR ID - 16113 TI - Two-stage Total Knee Arthroplasty for Treatment of Surgical Failure of Septic Arthritis in Degenerative Knee Joints JO - The Archives of Bone and Joint Surgery JA - ABJS LA - en SN - 2345-4644 AU - Tahmasebi, Mohammad Naghi AU - Sharafat Vaziri, Arash AU - Miresmaeili, Seyed Hossein AU - Bozorgmanesh, Mohammad Reza AU - Mirkarimi, Shahin AU - Zehtab, Mohammad Javad AU - Tahami, Mohammad AD - Department of Orthopedics, Tehran University of Medical Sciences, Tehran ,Iran AD - Department of orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Bone and Joint Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Y1 - 2020 PY - 2020 VL - 8 IS - 4 SP - 524 EP - 530 KW - Degenerative joint KW - Septic knee arthritis KW - Total knee replacement KW - Two stage arthroplasty DO - 10.22038/abjs.2020.43184.2178 N2 - Background: The ultimate goal of the treatment of infectious knee arthritis is to protect the articular cartilage fromadverse effects of infection. Treatment, however, is not always hundred percent successful and has a 12% failurerate. Persistent infection is more likely to happen in elderly patients and those with underlying joint diseases,particularly osteoarthritis. Eradication of infection and restoration of function in the involved joint usually arenot possible by conventional treatment strategies. There are few case series reporting two-stage primary kneearthroplasty as the salvage treatment of the septic degenerative knee joint; however, the treatment protocol remainsto be elucidated.Methods: Based on a proposed approach, patients with failure of common interventions for treatment of septic kneearthritis and underlying joint degeneration were treated by two-stage TKA and intervening antibiotic loaded staticcement spacer. Suppressive antibiotic therapy was not prescribed after the second stage.Results: Complete infection eradication was achieved with mean follow up of 26 months. All cases were balanced withprimary total knee prosthesis. The knee scores and final range of motions were comparable to other studies.Conclusion: The two-stage total knee replacement technique is a good option for management of failure of previoussurgical treatment in patients with septic arthritis and concomitant joint degeneration. Our proposed approach enabledus to use primary prosthesis in all of our patients with no need for suppressive antibiotic therapy.Level of evidence: IV UR - https://abjs.mums.ac.ir/article_16113.html L1 - https://abjs.mums.ac.ir/article_16113_745cc4576d70931c379668ad9a630a67.pdf ER -