Evidence map›Paper›PMID 23895421›Full record

SynthesisBMC musculoskeletal disorders2013

A systematic review of the evidence for single stage and two stage revision of infected knee replacement.

James P M Masters, Nicholas A Smith, Pedro Foguet, Mike Reed, Helen Parsons, Andrew P Sprowson

Registry-linked trialAbstract readComparative StudySystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03435679 (One-stage Versus Two-stage Revision of the Infected Knee Arthroplasty. a Randomized Controlled Multicenter Trial.), which is not on this map. Cited by 60 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03435679 naactive not recruitingnot on this mapstarted 2018, after this paper: background citation

One-stage Versus Two-stage Revision of the Infected Knee Arthroplasty. a Randomized Controlled Multicenter Trial.

TypeinterventionalSponsorOdense University HospitalRan2018 to 2026Enrolled97ConditionsPeriprosthetic Knee InfectionArmsone-stage, two-stage
3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  4. Is prosthesis retention effective for chronic infections in hip arthroplasties? A systematic literature review.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2015
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

James P M MastersUniversity of Warwick, Clinical Sciences Buildings, University Hospital Coventry, Coventry CV2 2DX, UK. j.masters@warwick.ac.uk
Nicholas A Smith
Pedro Foguet
Mike Reed
Helen Parsons
Andrew P Sprowson

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeriprosthetic infection about the knee is a devastating complication that may affect between 1% and 5% of knee replacement. With over 79 000 knee replacements being implanted each year in the UK, periprosthetic infection (PJI) is set to become an important burden of disease and cost to the healthcare economy. One of the important controversies in treatment of PJI is whether a single stage revision operation is superior to a two-stage procedure. This study sought to systematically evaluate the published evidence to determine which technique had lowest reinfection rates.

methodsA systematic review of the literature was undertaken using the MEDLINE and EMBASE databases with the aim to identify existing studies that present the outcomes of each surgical technique. Reinfection rate was the primary outcome measure. Studies of specific subsets of patients such as resistant organisms were excluded.

results63 studies were identified that met the inclusion criteria. The majority of which (58) were reports of two-stage revision. Reinfection rated varied between 0% and 41% in two-stage studies, and 0% and 11% in single stage studies. No clinical trials were identified and the majority of studies were observational studies.

conclusionsEvidence for both one-stage and two-stage revision is largely of low quality. The evidence basis for two-stage revision is significantly larger, and further work into direct comparison between the two techniques should be undertaken as a priority.

Indexed as

Arthroplasty, Replacement, KneeHumansKnee ProsthesisMEDLINEProsthesis-Related InfectionsReoperationTreatment Outcome

Identifiers

PMID23895421
PMCPMC3734185

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.