Preoperative prediction of failure following two-stage revision for knee prosthetic joint infections

J Arthroplasty. 2014 Jan;29(1):115-21. doi: 10.1016/j.arth.2013.04.016. Epub 2013 May 23.

Abstract

While two-stage revision is the gold standard for treatment of knee prosthetic joint infection (PJI), it is not without risk. The purpose of this study was to develop a tool to preoperatively predict the probability that a two-stage revision would fail to eradicate knee PJI. 3,809 surgical cases were retrospectively reviewed and data were collected from 314 charts. Overall, 105 (33.4%) cases failed to eradicate PJI using this procedure. Univariate analysis identified multiple variables independently associated with reinfection. Logistic regression was used to generate a model (bootstrap-corrected concordance index of 0.773) predicting failure of infection eradication. Preoperative knowledge of a high probability of failure may improve risk assessment, lead to more aggressive management, and allow for time to consider alternative therapies.

Keywords: infection; nomogram; predictive modeling; revision; total knee arthroplasty.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Female
  • Humans
  • Knee Joint / surgery*
  • Knee Prosthesis / adverse effects*
  • Knee Prosthesis / microbiology
  • Male
  • Middle Aged
  • Nomograms
  • Preoperative Period
  • Prognosis
  • Proportional Hazards Models
  • Prosthesis Failure*
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / surgery*
  • Reoperation
  • Retrospective Studies
  • Risk Assessment
  • Young Adult