A single-center retrospective cohort study was conducted in the Department of Orthopedics, the First Affiliated Hospital of Fujian Medical University. This study reviewed 145 patients who underwent debridement, antibiotics, and implant retention (DAIR), 1-stage revision, 1.5-stage revision, and 2-stage revision surgeries for total knee arthroplasty periprosthetic joint infection (TKA-PJI) at this institution between 2012 and 2022. The differences in postoperative reinfection rate, microbial composition of reinfection, short-term and long-term aseptic prosthesis survival rate, prosthesis loosening and revision rate due to any cause, and long-term loosening-free survival rate among the four revision surgical approaches for TKA-PJI were evaluated, so as to provide reference value for clinical decision-making.

A single-center retrospective cohort study was conducted in the Department of Orthopedics, the First Affiliated Hospital of Fujian Medical University. This study reviewed 145 patients who underwent debridement, antibiotics, and implant retention (DAIR), 1-stage revision, 1.5-stage revision, and 2-stage revision surgeries for total knee arthroplasty periprosthetic joint infection (TKA-PJI) at this institution between 2012 and 2022. In this study, we aimed to evaluate: (1) the postoperative reinfection rates following four surgical strategies for TKA-PJI; (2) the microbial profile of recurrent infections; (3) short- and long-term infection-free implant survival rates across the four surgical approaches; (4) re-revision rates due to aseptic loosening and long-term aseptic loosening-free implant survival rates; and (5) the reinfection rate in patients with positive cultures at the time of reimplantation. In order to provide reference value for clinical decision-making.

Inclusion Criteria

1. Patients who met the diagnostic criteria for TKA-PJI;
2. Patients who underwent one of the following surgical interventions: DAIR, one-stage revision, 1.5-stage revision, or two-stage revision;
3. Patients with complete medical records available;
4. Patients who provided informed consent to participate in the study.

Exclusion Criteria:

1. Incomplete medical records;
2. Poor follow-up compliance, including inability to complete scheduled follow-up visits or refusal to participate in follow-up;
3. Follow-up duration less than 2 years.

According to the inclusion criteria, 145 patients who underwent DAIR, phase 1 revision, phase 1.5 revision, and phase 2 revision surgery for TKA-PJI at the institution between 2012 and 2022 were selected. All patients have completed at least 2 years of follow-up. Follow up includes prosthesis loosening, infection recurrence rate, infection recurrence rate, infection new incidence rate, bacterial positive culture rate, infection free survival rate, and revision rate for any reason.

Sampling Method