Technique and timing of two-stage exchange for infection in TKA.

Technique and timing of two-stage exchange for infection in TKA. Research Abstract Details 

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Technique and timing of two-stage exchange for infection in TKA. Abstract Text:

R Stephen J Burnett,Michael A Kelly,Arlen D Hanssen,Robert L Barrack,R Stephen J Burnett,Michael A Kelly,Arlen D Hanssen,Robert L Barrack,

Infection in total knee arthroplasty is a devastating complication. The two-stage exchange procedure has evolved as an effective treatment option. The classification and alternatives to a two-stage procedure are presented. Current diagnosis and monitoring of infection in total knee arthroplasty with laboratory, aspiration, and imaging techniques are reviewed. The timing, technique, and results of a two-stage procedure are discussed. A knee aspiration with synovial fluid cell count and culture may be a useful adjunct. The use of antibiotic-impregnated cement spacers may be considered at the first-stage surgery. Spacers may be static or articulating, intramedullary dowels, preformed or constructed in the operating room, and provide single- or multiple-agent antibiotic (and antifungal) joint space delivery. Proper technique, antibiotic dosing, and indications with these devices will avoid complications between stages. The most common complications encountered with the use of spacers include dislocation/instability, implant extrusion, overstuffing of the patellofemoral and tibiofemoral joints, and implant or periprosthetic fracture. At the second stage of the procedure, surgical exposure, intraoperative frozen sections, assessment of bone and soft tissue defects, the integrity of the extensor mechanism, and implant selection are important factors to consider in the second-stage reimplantation revision total knee arthroplasty. LEVEL OF EVIDENCE: Level V, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Technique and timing of two-stage exchange for infection in TKA. Publishing Authors By Initials

RS Burnett,MA Kelly,AD Hanssen,RL Barrack,RS Burnett,MA Kelly,AD Hanssen,RL Barrack,

For similar surgical procedures, operative: reoperation research abstracts see: surgical procedures, operative: reoperation research

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Technique and timing of two-stage exchange for infection in TKA. Journal Published:

PUBLICATION TYPE: Review

Journal: Clinical orthopaedics and related research

VOLUME: 464

Page Numbers: 164-78

Journal Abbreviation: Clin. Orthop. Relat. Res.

ISSN: 0009-921X

DAY: 2

MONTH: Nov

YEAR: 2007

Technique and timing of two-stage exchange for infection in TKA. Information

Number of References: 64

LANGUAGE: eng

NlmUniqueID: 75674

Technique and timing of two-stage exchange for infection in TKA. Keywords Mesh Terms:

KEYWORDS: Reoperation

MESH TERMS: methods

Chemical & Substance for Abstract: Technique and timing of two-stage exchange for infection in TKA. Information

Substance Name: Bone Cements

Registry Number: 0

Grant and Affiliation Information for Technique and timing of two-stage exchange for infection in TKA.

AFFILIATION: Department of Orthopaedic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, MO 63110, USA.

Country: United States

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MEDLINETA: Clin Orthop Relat Res

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