Clinical Outcome after Septic versus Aseptic Revision Total Knee Arthroplasty

Chul-Won Ha; Jeong-Seok Moon

doi:10.4055/jkoa.2008.43.1.72

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Ha and Moon: Clinical Outcome after Septic versus Aseptic Revision Total Knee Arthroplasty

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(1): 72-77.

Published online: 29 February 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.1.72

Clinical Outcome after Septic versus Aseptic Revision Total Knee Arthroplasty

Chul-Won Ha, M.D., Jeong-Seok Moon, ^*

Department of Orthopedic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Korea.

^*Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University, Seoul, Korea.

Address reprint requests to Chul-Won Ha, M.D. Department of Orthopedic Surgery, Samsung Medical center, School of Medicine, Sungkyunkwan Univiersity, 50, Ilwong-dong, Gangnam-gu, Seoul 135-710, Korea. Tel: +82.2-3410-0275, Fax: +82.2-3410-0084, hacw@skku.edu

Abstract

Purpose

The purpose of this study was to compare the clinical outcomes of septic and aseptic revision total knee arthroplasty.

Materials and Methods

This study compared the clinical and radiographic results of 12 septic and 10 aseptic revisions. All septic revisions were treated with two-stage reimplantation using an articulating cement spacer. The range of motion, Knee Society score, WOMAC score, and radiographic results of the American Knee Society were assessed.

Results

The preoperative data, which included the average range of motion, Knee Society score, WOMAC score and femoro-tibial angle, were similar in both groups. At the final follow-up, the average range of motion was similar in the two groups: 102.5° in the septic revisions, and 114.5° in the aseptic revisions (p=0.070). In addition, the Knee Society score, WOMAC score and femoro-tibial angle were similar in both groups. There was no loosening or failure of either component observed in any case. A patellar tendon rupture was observed in one septic revision after surgery.

Conclusion

Two-stage reimplantation using an articulating cement spacer in septic revisions could achieve functional results that are compatible to aseptic revisions.

Keywords: Septic, Aseptic, Revision, Total knee arthroplasty

Figures and Tables

Fig. 1

Photographs of the articulating cement spacer. Excellent reproduction of the articular geometry was possible using a previously made mold application over the antibiotics-impregnated bone cement. Therefore, joint congruity and stability could be reproduced in flexion (A) and extension (B).

Table 1

Preoperative Demographic Data of the Septic and Aseptic Revision Total Knee Arthroplasty

^*Op., operative.

Table 2

Clinical Results of the Septic and Aseptic Revision Total Knee Arthroplasty

^*ROM, range of motion; ^†KSKS, Knee Society knee score; ^‡KSFS, Knee Society function score; ^§FTangle, femoro-tibial angle (varus; +, valgus; -).

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