• Arch Orthop Trauma Surg · Feb 2023

    Review

    Periprosthetic joint infection in unicompartmental knee arthroplasty: treatment options and outcomes. What is the current evidence in literature?

    • Andrea Zanirato, Luca Cavagnaro, Francesco Chiarlone, Emanuele Quarto, and Matteo Formica.
    • IRCCS Ospedale Policlinico San Martino-Clinica Ortopedica, Largo Rosanna Benzi 10, 16132, Genova, GE, Italy. dott.zanirato@gmail.com.
    • Arch Orthop Trauma Surg. 2023 Feb 1; 143 (2): 103110391031-1039.

    IntroductionPeriprosthetic joint infections (PJI) following unicompartmental knee arthroplasties (UKAs) will increase. The aim of this review is to evaluate current evidence regarding treatment options, complications, clinical and radiological outcomes of PJI management in UKAs.MethodsA systematic review of English literature was performed. Retrospective and prospective studies providing treatment options, complications, clinical and radiological outcomes of PJI following UKAs were included. PJI type, treatment, survival rate with no reoperation for infection and survival rate with no reoperation for any cause were evaluated.ResultsEleven articles were included. Three studies focusing on PJI following UKA (45 cases) report a survival rate with no reoperation for infection of 68.9% and a survival rate with no reoperation for any cause of 48.9%. Eight articles concerning UKA failure modes (28 cases) overestimate survival rate with no reoperation for infection (88.9%) and survival rate with no reoperation for any cause (88.9%) (p < 0.05). DAIR reports a rate of infection eradication failure ranging from 43.8 to 100%. 1SE allows for a survival rate with no reoperation for infection of 100%. 2SE reports a rate of infection eradication failure ranging from 0 to 12.5%. A high rate of early aseptic reoperation is reported, despite infection eradication (20% in DAIR; 28.5% in 2SE).ConclusionsTreatment strategy is determined by symptom timing, PJI type (acute vs chronic), causative organism, patient's comorbidities. A longer duration of PJI or severe host and extremity status seems to require 2SE or 1SE. Patients who have a shorter duration of PJI could receive DAIR.© 2022. The Author(s).

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