Figures & data
Table 1. Data on the infected prostheses (69 THRs and 20 TKRs) scored according to the different staging of the host and wound, and classification of the infection. The numbers of THRs and TKRs are given for each subclass, as are the results of the treatments
Figure 1. Gentamicin-PMMA beads (Septopal) inserted in a total knee replacement after debridement with retained prosthesis. Beads are mainly placed in the suprapatellar bursa and are removed after 2 weeks by another operation under general anesthesia, but with a smaller incision.
Figure 2. Radiographic appearance of a TKR in 2 directions. Gentamicin-PMMA beads are visible in the suprapatellar bursa and on the lateral side of the joint. Beads cannot be positioned in the posterior joint due to the limited space.
Figure 3. THR with gentamicin-PMMA beads intra-articularly around the neck of the prosthesis and in the subcutaneous tissues. Antero-posterior radiograph on the first day after the debridement operation. Only a limited number of beads could be placed in this joint after the debridement. In the subcutaneous tissue, beads were placed in an abscess cavity.
Table 2. Numbers of debridements and local antibiotic carriers in 89 THR and TKR infections. Detailed numbers are given to specify whether beads were used with or without fleeces (at the last operation), or only fleeces, with numbers of successful or failed treatments
Table 3. Causative bacteria in 89 prosthesis infections
Table 4. Bacteria present in the 27 polymicrobial infections as depicted in
Figure 4. Risk (with 95% CI) for failure of the treatment of an infected prosthesis if treated at or after a particular postoperative time interval.
Figure 5. Relation between the relative risk (RR) for successful treatment of an infected prosthesis and the postoperative interval in weeks. The RR is expressed as success if a treatment started after ≥ N weeks, as compared to the period < N weeks. The null hypothesis of RR = 1.0 is represented by a broken line.
