Removal and successful re-implantation of a customized interpositional knee device following an early postoperative infection: A case report

• Autorzy: Franz Koeck , Bjoern Rath , Hans-Robert Springorum , Markus Tingart , Joachim Grifka , Johannes Beckmann
• Języki publikacji: EN

Abstrakty

EN

We report the first case of early postoperative infection after a medial hemiarthroplasty of the knee with a customized ConforMIS iForma™ interpositional device. The infection was treated successfully by revision surgery with implant removal and antibiotic therapy. Despite the additional diagnosis of rheumatoid arthritis that did not affect the treated knee, the preservation of bony and ligamentous structures enabled a successful re-implantation of another iForma™ implant 9 months later with good clinical results at follow-up examination 1 year postoperatively. This is very much in contrast to the extensive and complex revision surgery, with significant bone loss, in patients with infected unicompartmental or total knee arthroplasties. The iForma™ device may be an alternative treatment option in early and moderate unicompartmental arthritis of the knee, with easy revision with the same type of implant in the rare case of infection.

Słowa kluczowe

EN

Unicompartmental osteoarthritis; Knee interpositional device; Hemiarthroplasty; Complication

• Czasopismo: Open Medicine
• Rocznik: 2010
• Tom: 5
• Numer: 4
• Strony: 442-446

Daty

wydano

2010-08-01

online

2010-05-30

Twórcy

autor

Franz Koeck

• Department of Orthopaedic Surgery, University of Regensburg, 93077, Bad Abbach, Germany,

autor

Bjoern Rath

• Department of Orthopaedic Surgery, University of Regensburg, 93077, Bad Abbach, Germany

autor

Hans-Robert Springorum

• Department of Orthopaedic Surgery, University of Regensburg, 93077, Bad Abbach, Germany

autor

Markus Tingart

• Department of Orthopaedic Surgery, University of Regensburg, 93077, Bad Abbach, Germany

autor

Joachim Grifka

• Department of Orthopaedic Surgery, University of Regensburg, 93077, Bad Abbach, Germany

autor

Johannes Beckmann

• Department of Orthopaedic Surgery, University of Regensburg, 93077, Bad Abbach, Germany

Bibliografia

• [1] MacIntosh D.L., Hemiarthroplasıy of the knee using a space occupying prosthesis for painful varus and valgus deformities. In Proceedings of the Joint Meeting of the Orthopaedic Associations of the English-Speaking World. J. Bone Joint Surg. [Am], 1959, 40, 1431
• [2] McKeever D.C., Elliott R.B. Tibial plateau prosthesis. Clin. Orthop. Rel. Res., 1960, 18, 86–95
• [3] Scott R.D., Joyce M.J., Ewald F.C., Thomas W.H., McKeever metallic hemiarthroplasty of the knee in unicompartmental degenerative arthritis. Longterm clinical follow-up and current indications. J. Bone Joint Surg. [Am], 1985, 67, 203–207
• [4] Emerson R., Potter T., The use of the McKeever metallic hemiarthroplastsy for unicompartmental arthritis. J. Bone Joint Surg. [Am], 1988, 67, 208–2012
• [5] Springer B.D., Scott R.D., Sah A.P., Carrington R., McKeever hemiarthroplasty of the knee in subjects less than sixty years old. J. Bone Joint Surg. [Am], 2006, 88, 366–371 http://dx.doi.org/10.2106/JBJS.E.00123[Crossref]
• [6] Hastings D.E., Hewitson W.A., Double hemiarthroplasty of the knee in rheumatoid arthritis. A survey of fifty consecutive cases. J. Bone Joint Surg. [Br] 1973, 55, 112–118
• [7] Bailie A.G., Lewis P.L., Brumby S.A., Roy S., Paterson R.S., Campbell D.G., The Unispacer knee implant: Early clinical results. J. Bone Joint Surg. [Br], 2008, 90, 446–450 http://dx.doi.org/10.2106/JBJS.F.01552[Crossref][WoS]
• [8] Hallock R.H., Fell B.M., Unicompartmental tibial hemiarthroplasty: early results of the UniSpacer knee. Clin. Orthop. Relat. Res., 2003, 416, 154–163 http://dx.doi.org/10.1097/01.blo.0000093031.56370.90[Crossref]
• [9] Sisto D.J., Mitchell I.L., Unispacer arthroplasty of the knee. J. Bone Joint Surg. [Am], 2005, 87, 1706–1711 http://dx.doi.org/10.2106/JBJS.D.02339[Crossref]
• [10] Koeck F.X., Perlick L., Luring C., Handel M., Beckmann J., Linhardt O., Grifka J., Leg axis correction with ConforMIS iForma™ (interpositional device) in unicompartmental arthritis of the knee. Int. Orthop., 2008, 33, 955–960 http://dx.doi.org/10.1007/s00264-008-0577-0[WoS][Crossref]
• [11] Chesney D., Sales J., Elton R., Brenkel I.J,. Infection after knee arthroplasty a prospective study of 1509 cases. J. Arthroplasty, 2008, 23, 355–359 http://dx.doi.org/10.1016/j.arth.2007.05.052[Crossref]
• [12] Jämsen E., Huotari K., Huhtala H., Nevalainen J., Konttinen Y.T., Low rate of infected knee replacements in a nationwide series-is it an underestimate? Acta Orthop., 2009, 80, 205–212 http://dx.doi.org/10.3109/17453670902947432[WoS][Crossref]
• [13] Jämsen E., Huhtala H., Puolakka T., Moilanen T., Risk factors for infection after knee arthroplasty. A register-based analysis of 43,149 cases. J. Bone Joint Surg. [Am], 2009, 91, 38–47 http://dx.doi.org/10.2106/JBJS.G.01686[Crossref]
• [14] Zimmerli W., Ochsner P.E., Management of infections associated with prosthetic joints. Infection, 2003, 31, 93–102 http://dx.doi.org/10.1007/s15010-002-3079-9[Crossref]
• [15] MacIntosh D.L., Hunter G.A., The use of the hemiarthroplasty prosthesis for advanced osteoarthritis and rheumatoid arthritis of the knee. J. Bone Joint Surg. [Br], 1972, 54, 244–255
• [16] Potter T.A., Weinfeld M.S., Thomas W.H., Arthroplasty of the knee in rheumatoid arthritis and osteoarthritis. A follow-up study after implantation of the McKeever and MacIntosh prostheses. J. Bone Joint Surg. [Am], 1972, 54, 1–24
• [17] Bellamy N., Buchanan W.W., Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J. Rheumatol., 1988, 15, 1833–1840
• [18] Whitehouse S.L., Lingard E.A., Katz J.N., Learmonth I.D., Development and testing of a reduced WOMAC function scale. J. Bone Joint Surg. [Br], 2003, 85, 706–711
• [19] Stengel D., Bauwens K., Sehouli J., Ekkernkamp A., Porzsolt F.. Systematic review and meta-analysis of antibiotic therapy for bone and joint infections. Lancet infect dis. 2001, 1, 175–188 http://dx.doi.org/10.1016/S1473-3099(01)00094-9[Crossref]

Identyfikatory

DOI

10.2478/s11536-009-0135-1