2025 ISAKOS Biennial Congress ePoster
Periprosthetic Joint Infections In The Knee: Can We Identify An Ideal Candidate For The 1.5-Stage Revision?
Giovanni Balato, Prof. ITALY
Tiziana Ascione, MD, Naples ITALY
Domenico De Mauro, MD ITALY
Enrico Festa, MD, Naples ITALY
Donato Di Gennaro, MD, Naples ITALY
Lucrezia Marasco, MD, Naples ITALY
Federico II University, Naples, ITALY
FDA Status Not Applicable
Summary
1-stage and 2-stage are the most popular as surgical options in chronic PJI, demostrating valuable therapeutic successes in patients outcome. 1.5-stage represents a solid option, too, but indications to this treatment are still unclear.
ePosters will be available shortly before Congress
Abstract
Background
Periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) is a serious and demanding complication to manage. Treatment options are different and each one represent an appropriate choice only with correct indications. 1-stage and 2-stage are the most popular as surgical options in chronic PJI, demostrating valuable therapeutic successes in patients outcome. 1.5-stage represents a solid option, too, but indications to this treatment are still unclear. The study aims to identify the ideal candidate for 1.5-stage by evaluating outcome predictors of patients' QoL.
Study Design & Methods: A retrospective observational study was developed. All the patients treated with a metal-on-poly spacer for chronic PJI were included. Among them, were selected the patients retaining the articulating spacer after the 3-months evaluation (1.5-stage). The EQ-5D-5L Index Value, WOMAC, and KSS were assessed preoperatively and before scheduling the reimplantation. The infection eradication was defined as the disappearance of all evidence of PJI during the 96-week follow-up period. Univariate analysis was chosen for each parameter, and only significant variables were chosen for multivariate analysis.
Results
The study included 108 patients with a median age of 73 (46–91) years. Thirty-six patients retained the spacer (1.5 stage). Age over 73 years, Charlson comorbidity index > 5, and revision implant infection were the most important determinants of choosing 1.5-stage revision. The Womac score registered before scheduling the reimplantation was inversely correlated to the spacer retaining.
Conclusions
Retaining the spacer (1.5 stage) should be reserved for elderly patients (>73 years) with severe comorbidities (CCI > 5) and with revision prostheses infection that reported a good function with the spacer in place.