Evidence map›Paper›PMID 25695981›Full record

Trial reportThe Journal of bone and joint surgery. American volume2015

Unsatisfactory outcome of arthrodesis performed after septic failure of revision total knee arthroplasty.

Eric Röhner, Christoph Windisch, Katy Nuetzmann, Max Rau, Michael Arnhold, Georg Matziolis

Abstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Journal of bone and joint surgery. American volume, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  19. [Treatment of periprosthetic infections].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2016
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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.

Eric RöhnerOrthopaedic Department, Friedrich-Schiller-University, Campus Eisenberg, Klosterlausnitzer Strasse 81, Jena, 07607 Eisenberg, Germany. E-mail address for E. Röhner: e.roehner@krankenhaus-eisenberg.de.
Christoph WindischOrthopaedic Department, Friedrich-Schiller-University, Campus Eisenberg, Klosterlausnitzer Strasse 81, Jena, 07607 Eisenberg, Germany. E-mail address for E. Röhner: e.roehner@krankenhaus-eisenberg.de.
Katy NuetzmannOrthopaedic Department, Friedrich-Schiller-University, Campus Eisenberg, Klosterlausnitzer Strasse 81, Jena, 07607 Eisenberg, Germany. E-mail address for E. Röhner: e.roehner@krankenhaus-eisenberg.de.
Max RauOrthopaedic Department, Friedrich-Schiller-University, Campus Eisenberg, Klosterlausnitzer Strasse 81, Jena, 07607 Eisenberg, Germany. E-mail address for E. Röhner: e.roehner@krankenhaus-eisenberg.de.
Michael ArnholdOrthopaedic Department, Friedrich-Schiller-University, Campus Eisenberg, Klosterlausnitzer Strasse 81, Jena, 07607 Eisenberg, Germany. E-mail address for E. Röhner: e.roehner@krankenhaus-eisenberg.de.
Georg MatziolisOrthopaedic Department, Friedrich-Schiller-University, Campus Eisenberg, Klosterlausnitzer Strasse 81, Jena, 07607 Eisenberg, Germany. E-mail address for E. Röhner: e.roehner@krankenhaus-eisenberg.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeriprosthetic infection is one of the most dreaded orthopaedic complications. Current treatment procedures include one-stage or two-stage revision total knee arthroplasty. If the periprosthetic infection is no longer controllable after several revision total knee arthroplasties, many surgeons regard knee arthrodesis as a promising option. The aim of our study was to ascertain whether intramedullary nailing results in the suppression or eradication of an infection and to identify risk factors for persistent infection.

methodsAll patients who had undergone intramedullary nailing following septic failure of revision total knee arthroplasty between 1997 and 2013 were included in the study. Pathogens, risk factors predisposing to persistent infection, and the rate of persistent infections were recorded. In addition, a visual analog scale (VAS) and Knee injury Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS), Lysholm, Short Form-36 (SF-36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires were completed to assess clinical outcomes and quality of life.

resultsTwenty-six patients were included in the study. Thirteen (50%) had a persistent infection requiring additional revision surgery. Nineteen patients (73%) reported persistent pain (VAS score of >3). All scores showed marked impairment of quality of life.

conclusionsIntramedullary nailing following septic failure of revision total knee arthroplasty must be regarded with skepticism, and we cannot recommend it. Repeat revision total knee arthroplasty or amputation should be considered as an alternative in such difficult cases.

Indexed as

Fracture Fixation, IntramedullaryProsthesis FailureAgedArthralgiaArthroplasty, Replacement, KneeHumansKnee ProsthesisOsteoarthritis, KneePain MeasurementProsthesis-Related InfectionsQuality of LifeRecurrenceReoperationRetrospective StudiesRisk Factors

Identifiers

PMID25695981
PMCPMC4325086

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.