Objective
To estimate in patients with Staphylococcus aureus prosthetic joint infection after total hip arthroplasty (THA) or total knee arthroplasty
(TKA) the microorganism-specific cumulative probability of treatment failure after
prosthesis removal and delayed reimplantation arthroplasty.
Patients and Methods
All patients with S aureus THA or TKA infection, according to a strict case definition, who were treated with
prosthesis removal and delayed reimplantation arthroplasty at Mayo Clinic Rochester
between 1980 and 1991 were identified. The study group comprised patients who were
free of infection at the time of reimplantation arthroplasty. This cohort was followed
up until treatment failure, infection with another organism, prosthesis removal, death,
or loss to follow-up occurred. The Kaplan-Meier survival method was used to estimate
the cumulative probability of treatment failure.
Results
Among 120 S aureus prosthetic joint infections treated with prosthesis removal during the study period,
38 episodes (22 THA, 16 TKA) in 36 patients met the study inclusion criteria. After
a median of 7.4 years (range, 0.9 year-16.4 years) of follow-up, treatment failure
occurred in 1 (2.6 %) of 38 episodes 1.4 years after reimplantation arthroplasty. The 5-year cumulative
probability of treatment failure was 2.8% (95% confidence interval, 0%-8.2%).
Conclusions
These data suggest that prosthesis removal and delayed reimplantation arthroplasty
is an effective treatment to limit the recurrence of S aureus prosthetic joint infection, provided there is no evidence of infection at the time
of reimplantation arthroplasty.
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Article Info
Footnotes
Presented in part at the 34th annual meeting of the Infectious Diseases Society of America (abstract 182), New Orleans, La, September 1996.
Identification
Copyright
© 1999 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
