부산대학교 도서관

Our objective was to evaluate different treatment alternatives for total knee arthroplasty (TKA) infection and to compare outcomes depending on adherence to a current treatment algorithm. All patients treated for a first episode of TKA infection between January 2000 and July 2005 were included. Patient records were reviewed and data were extracted retrospectively. Fifteen patients were followed up for a median of 25 months. The cure rate in patients with two-stage exchange of knee prosthesis was higher than in patients who had debridement without implant removal (100 vs 37%, p=0.03). Cure rates were not different between these two surgical approaches in ten patients who were treated according to a current treatment algorithm. Success rates for treatment of TKA infections varied considerably with the treatment strategy chosen. Our results support the use of existing algorithms to select patients who are eligible for debridement with retention of the prosthesis or need two-stage exchange of knee implants. Abstract (French): L'objectif est d'evaluer les differentes alternatives therapeutiques concernant les infections de protheses totales du genou et de mettre au point un algorithme de traitement. Patients et methode: tous les patients traites pour un premier episode d'infection de prothese totale du genou entre janvier 2000 et juillet 2005 ont ete inclus. Toutes les donnees concernant les patients et les dossiers medicaux ont ete analysees de facon retrospective. Resultats: 15 patients ont ete suivis pendant une moyenne de 25 mois. Les patients ayant beneficie d'un traitement en deux temps ont des resultats bien superieurs a ceux qui ont beneficie d'une simple mise a plat sans ablation d'implants (100% vs. 37% p=0,03). Neanmoins, les taux de guerison nA'ont pas ete differents chez 10 patients qui ont ete traites selon un algorithme therapeutique. En conclusion: les taux de succes du traitement des infections de protheses totales du genou peuvent varier considerablement selon la strategie therapeutique choisie. Nos donnees suggerent lA'utilisation dA'algorithme therapeutique pour selectionner les patients pouvant beneficier dA'une simple mis a plat sans ablation dA'implants, de ceux ayant besoin d'un traitement en deux temps.