Conversion From Knee Arthrodesis Back to Arthroplasty: A Particular Challenge in Combination With Fungal Periprosthetic Joint Infection.

Publication Title

Arthroplast Today

Authors

Sven Frieler, Swedish Medical Center, Swedish Neuroscience Institute, Seattle, WA, United StatesFollow
Emre Yilmaz, Swedish Medical Center, Swedish Neuroscience InstituteFollow
Ryan Goodmanson, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WashingtonFollow
Yannik Hanusrichter
Thomas A Schildhauer
Hinnerk Baecker

Document Type

Article

Publication Date

12-1-2020

Keywords

washington; seattle; swedish neuro

Abstract

A 58-year-old female treated at an outside facility with knee arthrodesis due to persistent periprosthetic joint infection fulfilled all prerequisites for a conversion back to arthroplasty, as part of a 2-stage revision. Owing to the detection of Candida parapsilosis, the treatment concept was converted to a three-stage procedure. A scheduled spacer exchange with additional amphotericin B-loaded polymethylmethacrylate was conducted as an intermediate revision before reimplantation. Conversion in the setting of fungal periprosthetic joint infection presents a challenge, and successful treatment hinges on the use of proper antifungal and antimicrobial protocols, advanced surgical techniques, and a multidisciplinary team approach. At the 3-year follow-up, successful infection eradication as measured by the Delphi-based consensus definition was achieved with a range of motion of 0°-100°.

Clinical Institute

Orthopedics & Sports Medicine

Clinical Institute

Neurosciences (Brain & Spine)

Specialty/Research Institute

Orthopedics

Specialty/Research Institute

Neurosciences

Specialty/Research Institute

Surgery