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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 2, 171-174.
doi: 10.1302/0301-620X.87B2.15640  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Is there a role for extended antibiotic therapy in a two-stage revision of the infected knee arthroplasty?

D. A. Hoad-Reddick, MBChB, FRCS(Tr & Orth), Cavendish Hip Fellow1; C. R. Evans, MBChB, FRCS(Tr & Orth), Consultant Orthopaedic Surgeon2; P. Norman, MA, MSc, MB, FRCPath, Consultant Microbiologist3; and I. Stockley, MD, FRCS, Consultant Orthopaedic Surgeon1

1 Department of Orthopaedic Surgery
2 The Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust, Gobowen, Oswestry, Shropshire SY10 7AG, UK.
3 Department of Microbiology Sheffield Teaching Hospitals Trust, Herries Road, Sheffield S5 7AU, UK.

Correspondence should be sent to Mr I. Stockley; e-mail: ian.stockley{at}sth.nhs.uk

All major studies have incorporated the use of prolonged courses of parenteral or oral antibiotic therapy in the management of two-stage revision of an infected total knee arthroplasty. We present a series of 59 consecutive patients, all with microbiologically-proven deep infection of a total knee arthroplasty, in whom a prolonged course of antibiotic therapy was not routinely used. The mean follow-up was 56.4 months (24 to 114).

Of the 38 patients who underwent a staged exchange, infection was successfully eradicated in 34 (89%) but recurrent or persistent infection was present in four (11%). Our rate of cure for infection is similar to that reported elsewhere. We conclude that a prolonged course of antibiotic therapy seems not to alter the incidence of recurrent or persistent infection. The costs of the administration of antibiotics are high and such a regime may be unnecessary.




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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General