Two-stage revision after total knee arthroplasty

Background and aim of the work: Periprosthetic knee infection is a complication associated with prosthetic failure; incidence change from 0,4-2% of primary total knee replacement and 5,6% in revisions; incidence is increasing over the years. Two-stage revision is the technique used in chronic infection. Aim of the work is to check success rate in our data. Methods: We analyzed retrospectively data of patients who undergone two stage revision surgery between 01/01/2010 to 31/12/2015. We made a clinical and radiological control after 1, 3, 6, 12, 24 months and we evaluate the outcome in December 2016. Results: Between 2010 and 2015 we treated 45 patients with two-stage revision. Mean follow-up was 3,4 years. Success rate is 89,9%. We had failure in 5 patients: everyone had knee surgery before first knee arthroplasty and Charlson Comorbidity Score was greater then 4 in 4 cases. Conclusions: Two stage revision can be considered a successful treatment in chronic periprosthetic knee infection. It has an optimal success rate, but it has some disadvantages as joint stiffness and pain in the interval between stages. This is a technique with two major surgery procedure with associated morbidity, discomfort, cost and prolonged stay in hospital. (www.actabiomedica.it