Sequential repeated tibial tubercle osteotomy in a two-stage exchange strategy : a superior approach to treating a chronically infected knee arthroplasty?
Corona Pérez-Cardona, Pablo S. (Vall d'Hebron Institut de Recerca (VHIR))
Pérez, M. (Hospital Universitari Vall d'Hebron)
Vicente Gomà-Camps, Matías (Vall d'Hebron Institut de Recerca (VHIR))
Pujol, Oriol (Hospital Universitari Vall d'Hebron)
Amat, Carles (Vall d'Hebron Institut de Recerca (VHIR))
Carrera, L. (Vall d'Hebron Institut de Recerca (VHIR))
Universitat Autònoma de Barcelona

Data:	2023
Resum:	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. 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. 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%, pvalue 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). 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.
Nota:	Altres ajuts: acords transformatius de la UAB
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Infection control ; Periprosthetic joint infection ; Tibial tubercle osteotomy ; Two-stage revision arthroplasty
Publicat a:	European journal of orthopaedic surgery & traumatology, 2023 , ISSN 1432-1068

DOI: 10.1007/s00590-023-03548-4
PMID: 37079110

9 p, 1.2 MB

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