Evidence map›Paper›PMID 30301462›Full record

SynthesisBMC musculoskeletal disorders2018

Re-infection rates and clinical outcomes following arthrodesis with intramedullary nail and external fixator for infected knee prosthesis: a systematic review and meta-analysis.

Giovanni Balato, Maria Rizzo, Tiziana Ascione, Francesco Smeraglia, Massimo Mariconda

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
3.3field-weighted citation impact, top 8% of its field
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

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.

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  11. Circular external fixation for knee fusion in complex indications.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023
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  13. Fusion rate of 89% after knee arthrodesis using an intramedullary nail: a mono-centric retrospective review of 48 cases.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023
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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

5 authors at 2 institutions in 1 country.

Giovanni BalatoDepartment of Public Health, Section of Orthopaedic Surgery, "Federico II" University, Via S. Pansini 5, Building 12, 80131, Naples, Italy. giovannibalato@gmail.com.
Maria RizzoDepartment of Public Health, Section of Orthopaedic Surgery, "Federico II" University, Via S. Pansini 5, Building 12, 80131, Naples, Italy.
Tiziana AscioneDepartment of Infectious Diseases, D. Cotugno Hospital - AORN dei Colli, Naples, Italy.
Francesco SmeragliaDepartment of Public Health, Section of Orthopaedic Surgery, "Federico II" University, Via S. Pansini 5, Building 12, 80131, Naples, Italy.
Massimo MaricondaDepartment of Public Health, Section of Orthopaedic Surgery, "Federico II" University, Via S. Pansini 5, Building 12, 80131, Naples, Italy.
Federico II University Hospital · ITOspedale D. Cotugno · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKnee arthrodesis with intramedullary (IM) nail or external fixator (EF) is the most reliable therapeutic option to achieve definitive infection control in patients with septic failure of total knee arthroplasty (TKA). The first aim of this study was to compare re-infection rates following knee arthrodesis for periprosthetic joint infection (PJI) with IM nail or EF. The second aim was to compare rates of radiographic union, complication, and re-operation as well as clinical outcomes.

methodsA systematic search was performed in electronic databases for longitudinal studies of PJIs (minimum ten patients; minimum follow-up = 1 year) treated by knee arthrodesis with IM nail or EF. Studies were also required to report the rate of re-infection as an outcome measure. Eligible studies were meta-analyzed using random-effect models.

resultsThe rate (95% confidence intervals) of re-infection was 10.6% (95% CI 7.3 to 14.0) in IM nail arthrodesis studies. The corresponding re-infection rate for EF was 5.4% (95% CI 1.7 to 9.1). This difference was significant (p = 0.009). The use of IM nail resulted in more advantages than EF for frequency of major complications and limb shortening. Other postoperative clinical and radiographic outcomes were similar for both surgical strategies.

conclusionsThe available evidence from the aggregate published data suggests that knee arthrodesis with EF in the specific context of PJI has a reduced risk of re-infection in comparison with the IM nail strategy. The use of IM nail is more effective for the complication rate and shortening of the affected limb.

Indexed as

Bone NailsExternal FixatorsAgedAged, 80 and overArthrodesisArthroplasty, Replacement, KneeFemaleHumansKnee ProsthesisMaleMiddle AgedProsthesis-Related InfectionsRecurrenceReoperationRisk FactorsTime FactorsExternal fixatorIntramedullary nailKnee arthrodesisKnee arthroplastyPeriprosthetic joint infectionRe-infection

Identifiers

PMID30301462
PMCPMC6178263
OpenAlexW2898006590

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LicenceCC BY
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Registered trials

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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.