Gold standard treatment of the patients with total knee arthroplasty infection

This study aimed to evaluate and compare early and mid-term results of the two-stage revision method used for diagnosing infections and giving treatment to patients who underwent total knee arthroplasty in Ankara Atatürk Research and Training Hospital, Turkey, between October 2013 and October 2015. Patient files were examined retrospectively, and patients were called for the last examination. Further, 23 patients were included in the study. The first and second stages of the two-stage revision were performed for all these patients. However, in 2 of these 23 patients, the process ended with arthrodesis and amputation. Infections were diagnosed based on the clinical examination of the knee, erythrocyte sedimentation rate, C-reactive protein, white blood cell counts, and intraoperative culture results. Laboratory parameters were also used for monitoring infection. Patients were evaluated preoperatively and postoperatively according to the American Knee Society clinical and functional scoring system. The mean age of the patients was 66.8 years. Also, 18 of the patients were female and 5 male. Early infection was detected in 4, delayed infection in 7, and late infection in 12 patients. The average follow-up time was 12.6 months. The American Knee Society clinical score was 35.0 (median score) preoperatively and 75.4 (median score) postoperatively. The functional score was 38.8 (median score) preoperatively and 77.3 (median score) postoperatively. In conclusion, early and mid-term results of patients with infected total knee prosthesis, who underwent the two-stage revision, were found to be consistent with the published results in terms of infection eradication success, radiological findings, and postoperative clinical and functional scores. It is possible to increase the success rate by approaching the cases in a standardized and systematic way.