Long Term Results of Two-Stage Revision for Chronic Periprosthetic Knee Infection: A Multicenter Study

Beau J. Kildow, Bryan D. Springer, Timothy S. Brown, Elizabeth R. Lyden, Thomas K. Fehring, Kevin L. Garvin

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Long-term reinfection and mortality rates and clinical outcomes with sufficient subject numbers remain limited for patients undergoing two-stage exchange arthroplasty for chronic periprosthetic knee infections. The purpose of this study was to determine the long-term reinfection, complication, and mortality following reimplantation for two-stage exchange following knee arthroplasty. Methods: Retrospective review of 178 patients who underwent two-stage exchange knee arthroplasty for chronic PJI at three large tertiary referral institutions with an average of 6.63-year follow-up from reimplantation from 1990 to 2015. Rates of reinfection, mortality, and all-cause revision were calculated along with the cumulative incidence of reinfection with death as a competing factor. Risk factors for reinfection were determined using Cox multivariate regression analysis. Results: Overall rate of infection eradication was 85.41%, with a mortality rate of 30.33%. Patients with minimum 5-year follow-up (n = 118, average 8.32 years) had an infection eradication rate of 88.98%, with a mortality rate of 33.05%. Conclusion: This is a large series with long-term follow-up evaluating outcomes of two-stage exchange knee arthroplasty resulting in adequate infection eradication and high mortality. Results were maintained at longer follow-up. This technique should be considered in patients with chronic PJI; however, realistic expectations regarding long-term outcomes must be discussed with patients.

Original languageEnglish (US)
Pages (from-to)S327-S332
JournalJournal of Arthroplasty
Issue number6S
StatePublished - Jun 2022


  • antibiotic resistance
  • arthroplasty
  • long-term
  • periprosthetic joint infection
  • reinfection
  • two-stage exchange
  • Arthroplasty, Replacement, Knee/adverse effects
  • Knee Joint/surgery
  • Humans
  • Treatment Outcome
  • Reoperation/adverse effects
  • Reinfection
  • Prosthesis-Related Infections/epidemiology
  • Retrospective Studies
  • Anti-Bacterial Agents/therapeutic use

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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