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J Knee Surg 2023; 36(03): 284-291
DOI: 10.1055/s-0041-1731739
Original Article

Midterm Survival of a Varus–Valgus Constrained Implant following One-Stage Revision for Periprosthetic Joint Infection: A Single-Center Study

Baochao Ji‡   *
1   Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
,
Guoqing Li‡   *
1   Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
,
Xiaogang Zhang
1   Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
,
Yang Wang
1   Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
,
Wenbo Mu
1   Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
,
Li Cao
1   Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
› Author Affiliations Funding This study was supported by the following grants: (1) Joint Funds of the National Natural Science Foundation of China, grant nos.: 81760398 and U1503221; (2) National Key Research and Development Program, grant no.: 2017YFB1304204; and (3) Natural Science Foundation of Xinjiang, grant no.: 2021D01C330.
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Abstract

Revision total knee arthroplasty (TKA) is challenging to perform in patients with periprosthetic joint infection (PJI) due to the difficulty of eradicating the infection and potential for bone and ligamentous deficits. The current study aimed to evaluate the midterm survival of varus–valgus constrained (VVC) implants used in one-stage revision TKA for chronic PJI at our institution. This retrospective analysis included 132 patients with chronic PJI who underwent one-stage revision using a VVC implant. The average follow-up was 51.6 months (range: 24–85 months). Five-year survival analysis was performed to set recurrent infection and mechanical failure as the end point. Hospital for special surgery (HSS) as functional outcomes was evaluated preoperatively and at the latest follow-up. A total of 12 patients (9.1%) underwent retreatment for reinfection (nine patients) and mechanical failure (three patients). The overall 5-year revision-free survival was 82.7%, the infection-free survival was 91.1%, and the mechanical failure-free survival was 98.3%. The preoperative HSS knee score improved from 35.6 points (range: 24.3–47.7 points) preoperatively to 76.8 points (range: 57.2–87.6 points) at the latest follow-up. Complications were identified in 20 patients (15.2%) which included aseptic osteolysis in 4 cases, acceptable flexion instability in 3 cases, arthrofibrosis in 2 patients, hematomas in 2 cases, calf intermuscular venous thrombosis in 6 patients, and femoral stem tip pain in 3 cases. This is the first study to report the outcomes of one-stage revision using VVC implants for knee PJI. Improved functional outcomes and good midterm survival are demonstrated at an average follow-up of 51.6 months.

Keywords

varus–valgus constrained Implant - one-stage revision - total knee arthroplasty - periprosthetic joint infection

* These authors contributed equally to the work described in the article and share first-author status.




Publication History

Received: 18 January 2021

Accepted: 31 May 2021

Article published online:
16 July 2021

© 2021. Thieme. All rights reserved.

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