Sistema de Salut de Catalunya
Institut Català de la Salut
[Corona PS, Vicente M, Amat C] Universitat Autònoma de Barcelona, Bellaterra, Spain. Servei de Cirurgia Ortopèdica i Traumatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Unitat de Cirurgia Sèptica i Reconstructiva, Servei de Cirurgia Ortopèdica i Traumatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Grup de Recerca d’Enginyeria Tissular Musculoesquelètica, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Pérez M] Universitat Autònoma de Barcelona, Bellaterra, Spain. Servei de Cirurgia Ortopèdica i Traumatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Departament de Cirurgia, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Pujol O] Universitat Autònoma de Barcelona, Bellaterra, Spain. Servei de Cirurgia Ortopèdica i Traumatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Carrera L] Universitat Autònoma de Barcelona, Bellaterra, Spain. Servei de Cirurgia Ortopèdica i Traumatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Unitat de Cirurgia Sèptica i Reconstructiva, Servei de Cirurgia Ortopèdica i Traumatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Grup de Recerca d’Enginyeria Tissular Musculoesquelètica, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Departament de Cirurgia, Universitat Autònoma de Barcelona, Bellaterra, Spain
Vall d'Hebron Barcelona Hospital Campus
2023-11-27T11:12:36Z
2023-11-27T11:12:36Z
2023-12
Periprosthetic joint infection; Tibial tubercle osteotomy; Two-stage revision arthroplasty
Infecció articular periprotèsica; Osteotomia del tubercle tibial; Artroplàstia de revisió en dues etapes
Infección articular periprotésica; Osteotomía del tubérculo tibial; Artroplastia de revisión en dos tiempos
Purpose Surgical approach can impact the reliability of the debridement after a chronic total knee periprosthetic joint infection (PJI), a factor of utmost importance to eradicate the infection. The most adequate knee surgical approach in cases of PJI is a matter of debate. The purpose of this study was to determine the influence of performing a tibial tubercle osteotomy (TTO) in a two-stage exchange protocol for knee PJI treatment. Methods Retrospective cohort study examining patients managed with two-stage arthroplasty due to chronic knee PJI (2010–2019). Performance and timing of the TTO were collected. Primary end-point was infection control with a minimum FU of 12 months and according to internationally accepted criteria. Correlation between TTO timing and reinfection rate was reviewed. Results Fifty-two cases were finally included. Overall success (average follow-up: 46.2 months) was 90.4%. Treatment success was significantly higher among cases addressed using TTO during the second stage (97.1% vs. 76.5%, p value 0.03). Only 4.8% of the patients relapsed after performing a sequential repeated TTO, that is, during both first and second stages, compared to 23.1% cases in which TTO was not done (p value 0.28). No complications were observed among patients in the TTO group with a significant decrease in soft tissue necrosis (p: 0.052). Conclusion Sequential repeated tibial tubercle osteotomy during a two-stage strategy is a reasonable option and offers high rates of infection control in complex cases of knee PJI with a low rate of complications.
Open Access Funding provided by Universitat Autònoma de Barcelona.
Article
Published version
English
Artroplàstia total de genoll; Osteotomia; Pròtesis; Genolls - Cirurgia - Complicacions; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Orthopedic Procedures::Osteotomy; DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications::Prosthesis-Related Infections; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Orthopedic Procedures::Arthroplasty::Arthroplasty, Replacement::Arthroplasty, Replacement, Knee; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos ortopédicos::osteotomía; ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias::infecciones relacionadas con prótesis; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos ortopédicos::artroplastia::artroplastia de sustitución::artroplastia de sustitución de rodilla
Springer
European Journal of Orthopaedic Surgery & Traumatology;33
https://doi.org/10.1007/s00590-023-03548-4
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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