Scientific article
Open access

Reduced infection rate after aseptic revision total knee arthroplasty with extended oral antibiotic protocol

Published inThe journal of arthroplasty, vol. 37, no. 5, p. 905-909
Publication date2022-05
First online date2022-01-22

Background: The optimal postoperative antibiotic duration has not been determined for aseptic revision total knee arthroplasty (R-TKA) where the risk of periprosthetic joint infection (PJI) is 3%-7.5%. This study compared PJI rates in aseptic R-TKA performed with extended oral antibiotic prophylaxis (EOAP) to published rates. Methods: Aseptic R-TKAs consecutively performed between 2013 and 2017 at a tertiary care referral center in the American Midwest were retrospectively reviewed. All patients were administered intravenous antibiotics while hospitalized and discharged on 7-day oral antibiotic prophylaxis. Infection rates and antibiotic-related complications were assessed. Results: Sixty-seven percent of the 176 analysis patients were female, with an average age of 64 years and body mass index of 35 kg/m2. Instability and aseptic loosening comprised 86% of revision diagnoses. Overall, 87.5% of intraoperative cultures were negative, and the remainder were single positive cultures considered contaminants. PJI rates were 0% at 90 days, 1.8% (95% confidence interval 0.4%-5.3%) at 1 year, and 2.2% (95% confidence interval 0.6%-5.7%) at mean follow-up of approximately 3 years (range, 7-65 months). Conclusion: EOAP after aseptic R-TKA resulted in a PJI rate equivalent to primary TKA, representing a 2- to-4-fold decrease compared with published aseptic R-TKA infection rates. Further study on the benefits and costs of EOAP after aseptic R-TKA is encouraged.

  • Extended antibiotic prophylaxis
  • Periprosthetic joint infection
  • Revision total knee arthroplasty
Citation (ISO format)
ZINGG, Matthieu et al. Reduced infection rate after aseptic revision total knee arthroplasty with extended oral antibiotic protocol. In: The journal of arthroplasty, 2022, vol. 37, n° 5, p. 905–909. doi: 10.1016/j.arth.2022.01.040
Main files (2)
Article (Accepted version)
Article (Published version)
Secondary files (1)
ISSN of the journal0883-5403

Technical informations

Creation01/26/2022 1:52:00 PM
First validation01/26/2022 1:52:00 PM
Update time03/16/2023 6:31:15 AM
Status update03/16/2023 6:31:13 AM
Last indexation02/12/2024 1:39:20 PM
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