Evidence map›Paper›PMID 39325167›Full record

ArticleArchives of orthopaedic and trauma surgery2024

Predictors of outcome following two-stage revision total knee arthroplasty.

Ashok Rajgopal, Vivek Dahiya, Ayush Bhatnagar, Sumit Kumar, Kalpana Aggarwal

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Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

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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

1 citing paper in PubMed.

  1. Review
4 · The record

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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.

Ashok RajgopalInstitute of Musculoskeletal Diseases and Orthopaedics, Medanta- The Medicity Hospital, Sector 38, Gurugram, Haryana, 122002, India. a_rajgopal@hotmail.com.
Vivek DahiyaInstitute of Musculoskeletal Diseases and Orthopaedics, Medanta- The Medicity Hospital, Sector 38, Gurugram, Haryana, 122002, India.
Ayush BhatnagarInstitute of Musculoskeletal Diseases and Orthopaedics, Medanta- The Medicity Hospital, Sector 38, Gurugram, Haryana, 122002, India.
Sumit KumarInstitute of Musculoskeletal Diseases and Orthopaedics, Medanta- The Medicity Hospital, Sector 38, Gurugram, Haryana, 122002, India.
Kalpana AggarwalInstitute of Musculoskeletal Diseases and Orthopaedics, Medanta- The Medicity Hospital, Sector 38, Gurugram, Haryana, 122002, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTwo stage revision arthroplasty remains the gold standard for peri-prosthetic joint infections of the knee. However, the functional outcomes of revision surgeries and the factors governing them require further investigation. The purpose of this study was to (a) evaluate impact of early and late stage I surgery and interval between stage I and stage II; (b) understand the impact of infecting organism and resistance; (c) to estimate long term survivorship and causes of failure.

methodsA retrospective review of 86 patients, who underwent two stage revision for prosthetic joint infections of the knee, was performed. Time between onset of symptoms to stage I (T1), and T1 to re-implantation (T2), along with microbiological studies, were analysed for their impact on functional outcomes, failure modalities and survivorship.

resultsIn this study, the mean KSS-Knee improved from 64.0 ± 10.0 pre-operatively to 76.9 ± 10.4, and 77.2 ± 10.1 at the 5 and 10 year follow up respectively. The KSS-Function improved from 44.4 ± 8.8 pre-operatively to 72.2 ± 9.5 and 79.8 ± 8.1 at 5 and 10 year follow-up respectively. This study also found that T1 and T2 remained critical factors in determining functional outcome and longevity of the implant and a delay in these intervals was a significant predictor of failure. Gram negative, poly-microbial infections and organisms with methicillin and vancomycin resistance demonstrated lower survivorship (p-value, 0.001 at 5, 10 and 12 years). Re-infections occurred in 4 cases while 9 cases failed due to aseptic causes.

conclusionTwo-stage revision arthroplasty produced good functional outcomes when the infection was caused by single sensitive organism that did not exhibit high resistance to antibiotics. Stage I performed within 4 weeks and the subsequent re-implantation procedure undertaken within 6 weeks demonstrated better outcomes.

Indexed as

Arthroplasty, Replacement, KneeProsthesis-Related InfectionsReoperationAdultAgedAged, 80 and overFemaleHumansKnee ProsthesisMaleMiddle AgedRetrospective StudiesTreatment OutcomeKnee society scoreProsthetic joint infectionStage 1 total knee replacementStage II total knee replacementTotal knee replacement

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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.