Above-the-knee amputation versus knee ...
Document type :
Article dans une revue scientifique: Article original
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Title :
Above-the-knee amputation versus knee arthrodesis for revision of infected total knee arthroplasty: recurrent infection rates and functional outcomes of 43 patients at a mean follow-up of 6.7 years
Author(s) :
Trouillez, Teddy [Auteur]
Centre de Référence des Infections Ostéo-Articulaires Complexes Nord-Ouest [CRIOAC-Lille-Tourcoing]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Faure, P. A. [Auteur]
Centre de Référence des Infections Ostéo-Articulaires Complexes Nord-Ouest [CRIOAC-Lille-Tourcoing]
Martinot, Pierre [Auteur]
Centre de Référence des Infections Ostéo-Articulaires Complexes Nord-Ouest [CRIOAC-Lille-Tourcoing]
Université Lille Nord (France)
Migaud, Henri [Auteur]
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]
Senneville, Eric [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Pasquier, Gilles [Auteur]
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]
Dartus, Julien [Auteur]
Centre de Référence des Infections Ostéo-Articulaires Complexes Nord-Ouest [CRIOAC-Lille-Tourcoing]
Université de Lille
Putman, Sophie [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Centre de Référence des Infections Ostéo-Articulaires Complexes Nord-Ouest [CRIOAC-Lille-Tourcoing]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Faure, P. A. [Auteur]
Centre de Référence des Infections Ostéo-Articulaires Complexes Nord-Ouest [CRIOAC-Lille-Tourcoing]
Martinot, Pierre [Auteur]
Centre de Référence des Infections Ostéo-Articulaires Complexes Nord-Ouest [CRIOAC-Lille-Tourcoing]
Université Lille Nord (France)
Migaud, Henri [Auteur]

Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]
Senneville, Eric [Auteur]

METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Pasquier, Gilles [Auteur]

Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]
Dartus, Julien [Auteur]
Centre de Référence des Infections Ostéo-Articulaires Complexes Nord-Ouest [CRIOAC-Lille-Tourcoing]
Université de Lille
Putman, Sophie [Auteur]

METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Journal title :
Orthopaedics & Traumatology: Surgery & Research
Abbreviated title :
Orthop Traumatol Surg Res
Volume number :
107
Pages :
102914
Publication date :
2021-06
ISSN :
1877-0568
English keyword(s) :
Above-the-knee amputation
Knee arthrodesis
Periprosthetic joint infection
Septic revision surgery
Sepsis
Knee arthrodesis
Periprosthetic joint infection
Septic revision surgery
Sepsis
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Introduction
In cases of repeated treatment failure of periprosthetic joint infections (PJI) of the knee, above–the–knee amputation (AKA) or knee arthrodesis can be proposed to reduce the risk of recurrent infection, ...
Show more >Introduction In cases of repeated treatment failure of periprosthetic joint infections (PJI) of the knee, above–the–knee amputation (AKA) or knee arthrodesis can be proposed to reduce the risk of recurrent infection, especially in cases with major bone defects or irreparable damage to the extensor mechanism of the knee. Since AKA versus knee arthrodesis results have been rarely assessed for these indications, we conducted a retrospective case-control study to compare both the rates of recurrent infection and functional outcomes. Hypothesis Patients who underwent AKA had fewer recurrent infections than those who had arthrodesis. Materials and methods Twenty patients who underwent AKA and 23 patients who had knee arthrodesis, between 2003 and 2019, were retrospectively included in this study. These two groups were comparable in age (73.8 versus 77.7 years (p = .31)) and sex (10 women and 10 men versus 16 women and seven men (p = .19)). Each group was analyzed individually and then compared in terms of survival (recurrent infection) and functional outcomes using clinical assessment scores (visual analog scale (VAS), French neuropathic pain questionnaire (DN4), Parker and Palmer mobility score and the 36-item short-form survey (SF–36)). Results The rate of recurrent infection was 10% (two out of 20 patients) for the AKA group and 21.75% (five out of 23 patients) for the arthrodesis group (p = .69). The mean follow-up for the AKA group was 4.18 years (1.2-11.8) and 9.7 years (1.1-14.33) for the arthrodesis group (p = .002). The number of previous revisions (three (1.5-4) for AKA and two (2-3) for arthrodesis) and the time between the primary arthroplasty and surgical procedure were significantly greater in the AKA group (48.0 (12.0-102.0) months) than the arthrodesis group (48.0 (24.0-87.0) months) (p < 001). The AKA group had significantly better clinical results for VAS (2.7 ± 2.2 vs. 3.1 ± 3.3), DN4 (1.5 ± 2.1 vs. 2.6 ± 2.9), Parker and Palmer (5.2 ± 1.7 vs. 4.6 ± 1.4), and SF–36 (30.9 ± 15.6 vs. 26.9 ± 17.0) (p < 001). Conclusion Above–the–knee amputation and knee arthrodesis showed no differences in the rate of recurrent sepsis. However, the comparison of the two groups demonstrated that patients who underwent an AKA had less pain, were more autonomous and had a better quality of life.Show less >
Show more >Introduction In cases of repeated treatment failure of periprosthetic joint infections (PJI) of the knee, above–the–knee amputation (AKA) or knee arthrodesis can be proposed to reduce the risk of recurrent infection, especially in cases with major bone defects or irreparable damage to the extensor mechanism of the knee. Since AKA versus knee arthrodesis results have been rarely assessed for these indications, we conducted a retrospective case-control study to compare both the rates of recurrent infection and functional outcomes. Hypothesis Patients who underwent AKA had fewer recurrent infections than those who had arthrodesis. Materials and methods Twenty patients who underwent AKA and 23 patients who had knee arthrodesis, between 2003 and 2019, were retrospectively included in this study. These two groups were comparable in age (73.8 versus 77.7 years (p = .31)) and sex (10 women and 10 men versus 16 women and seven men (p = .19)). Each group was analyzed individually and then compared in terms of survival (recurrent infection) and functional outcomes using clinical assessment scores (visual analog scale (VAS), French neuropathic pain questionnaire (DN4), Parker and Palmer mobility score and the 36-item short-form survey (SF–36)). Results The rate of recurrent infection was 10% (two out of 20 patients) for the AKA group and 21.75% (five out of 23 patients) for the arthrodesis group (p = .69). The mean follow-up for the AKA group was 4.18 years (1.2-11.8) and 9.7 years (1.1-14.33) for the arthrodesis group (p = .002). The number of previous revisions (three (1.5-4) for AKA and two (2-3) for arthrodesis) and the time between the primary arthroplasty and surgical procedure were significantly greater in the AKA group (48.0 (12.0-102.0) months) than the arthrodesis group (48.0 (24.0-87.0) months) (p < 001). The AKA group had significantly better clinical results for VAS (2.7 ± 2.2 vs. 3.1 ± 3.3), DN4 (1.5 ± 2.1 vs. 2.6 ± 2.9), Parker and Palmer (5.2 ± 1.7 vs. 4.6 ± 1.4), and SF–36 (30.9 ± 15.6 vs. 26.9 ± 17.0) (p < 001). Conclusion Above–the–knee amputation and knee arthrodesis showed no differences in the rate of recurrent sepsis. However, the comparison of the two groups demonstrated that patients who underwent an AKA had less pain, were more autonomous and had a better quality of life.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CHU Lille
CHU Lille
Collections :
Submission date :
2023-11-15T07:01:03Z
2024-04-10T06:25:38Z
2024-04-10T06:25:38Z