Revision Total Knee Arthroplasty for Periprosthetic Joint Infection
摘要
Revision total knee arthroplasty (rTKA) is challenging to carry out in individuals with periprosthetic joint infection (PJI) due to the difficulty of eliminating the infection and potential for bone and ligamentous deficits. There are two basic ways to resolve PJI after TKA: one-stage exchange and two-stage exchange. Individuals with synovial fluid leukocyte (WBC) counts of at least 934 and a neutrophil percentage (PMN) of 52% or more should not experience reimplantation but rather a repeat debridement, as their risk of persistent or recurrent PJI is prohibitively high. Contraindications to single-stage exchange include systemic sepsis, large osseous or soft-tissue loss, extensor mechanism failure, or if primary wound closure is unlikely to be accomplishable. Two-stage rTKA is the most frequently carried out revision procedure of a PJI.