The Parameters Affecting the Success of Irrigation and Debridement with Component Retention in the Treatment of Acutely Infected Total Knee Arthroplasty

BACKGROUND: The aims of our study were to evaluate the success rate of irrigation and debridement with component retention (IDCR) for acutely infected total knee arthroplasty (TKA) (< 4 weeks of symptom duration) and to analyze the factors affecting prognosis of IDCR. METHODS: We retrospectively reviewed 28 knees treated by IDCR for acutely infected TKA from 2003 to 2012. We evaluated the success rate of IDCR. All variables were compared between the success and failure groups. Multivariable logistic regression analysis was also used to examine the relative contribution of these parameters to the success of IDCR. RESULTS: Seventeen knees (60.7%) were successfully treated. Between the success and failure groups, there were significant differences in the time from primary TKA to IDCR (p = 0.021), the preoperative erythrocyte sedimentation rate (ESR; p = 0.021), microorganism (p = 0.006), and polyethylene liner exchange (p = 0.017). Multivariable logistic regression analysis of parameters affecting the success of IDCR demonstrated that preoperative ESR (odds ratio [OR], 1.02; p = 0.041), microorganism (OR, 12.4; p = 0.006), and polyethylene liner exchange (OR, 0.07; p = 0.021) were significant parameters. CONCLUSIONS: The results show that 60.7% of the cases were successfully treated by IDCR for acutely infected TKA. The preoperative ESR, microorganism, and polyethylene liner exchange were factors that affected the success of IDCR in acutely infected TKA.

Las actividades de enfermería en el transoperatorio en correlación con la incidencia de infección de la artroplastía de la rodilla y de la cadera / Transoperative nursing activities and their relationship to infection in prosthetic total replacement of the hip and knee

El presente estudio fue llevado a cabo en la sala de operaciones de ortopedia de enero de 1995 a mayo de 1998, con el fin de establecer si existe correlación entre la infeción en pacientes con reemplazo total de cadera o rodilla y las tareas realizadas por el personal de enfermeras instrumentistas en el campo de operaciones. El 0.6 por ciento de los pacientes con reemplazo total de cadera presentaron infección (2 entre 339) así como 5.2 por ciento de los pacientes con reemplazo total de rodilla (9 entre 170). Los cultivos obtenidos del campo operatorio fueron uniformemente negativos. En el presente trabajo se concluye que las actividades de la enfermera instrumentista no tienen influencia sobre la presencia de infecciones