Acute Periprosthetic Infections on Primary Knee Arthroplasty

Abstract:  Introduction The increase of life expectancy turns into an increase of lower limbs arthroplasty, indicated because of articular degeneration, becoming a usual practice. However, on the knee, the poor soft tissue coverage predisposes to infectious complications. The treatment...

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Autores principales: Contreras, VY, Hergenreder, VS, Zeballos Cabrera , MM, Quinteros , M, Simondi , N, Zárate, CL, Sanchez Carpio , DG
Formato: Artículo revista
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021
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Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/34933
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Sumario:Abstract:  Introduction The increase of life expectancy turns into an increase of lower limbs arthroplasty, indicated because of articular degeneration, becoming a usual practice. However, on the knee, the poor soft tissue coverage predisposes to infectious complications. The treatment for this requires a surgical debridement, infectious agents’s typification and specific antibiotic treatment. Even thought the preservation of the implant predominates over the retirement of it, some cases may require the extraction with posterior revisión once solved the infection.  Objective To analyse comorbidities and most usual germs associated to acute periprosthetic infections on primary knee arthroplasty.  Methods and material It was made a descriptive, transversal and retrospectiv study, which included patients treated between january 2017 and march 2020 with PKA secondary to arthrosis in ages between 60 and 80 years old. Were excluded patients less tan 60 years old, more tan 80 years old and revisión surgeries. They were selected those with acute infection (first 6 weeks after the procedure), comorbidities, treatment and identify germs.  Results Over the determined period, were intervened 82 patients, of which 12 (14.6%) had an acute infection. Of 12 cases, 50% were women, the 50% rested were men, being the 100% of them urban people.  3 were diabetic, 2 hypertensive, 3 were diabetic and hypertensive, 1 patient was obese and 1 had no illness.  The most frecuent germn isolated was Stafilococcus aureus MS on 7 cases (58.3%), Stafilococcus capitis (8.33%), Stafilococcus warneri (8.33%), Stafilococcus epidermidis MS (8.33%), Stafilococcus aureus MR (8.33%) and Pseudomona aeruginosa (8.33%). They all were treated with surgical debridements, 9 cases kept the primary implant, but in 3 cases it had to be removed.  Conclusions Althought acute periprosthetic infections are not frecuent, the presence of it leads to a high morbidity because of the need of multiple surgery debridements and long term treatment with antibiotics. It would be important the screening of sams, the most frecuent germ involved for presurgical treatment.