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All Journal The Hip and Knee Journal
Dicky Mulyadi
RSUP dr. Hasan Sadikin
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Neuroscience

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Modified Two-Stage Exchange for MRSA Periprosthetic Joint Infection in Total Knee Arthroplasty – Case Report Dicky Mulyadi
The Hip and Knee Journal Vol 4, No 1 (2023): February
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (3987.058 KB) | DOI: 10.46355/hipknee.v4i1.149

Abstract

BackgroundPeriprosthetic joint infection (PJI) of the knee is a catastrophic complication that occurs in 1-2 % of patients after total knee arthroplasty. As the number of primary knee arthroplasty procedures increases, thus will the number of periprosthetic infections continues to be a major challenge with a significant financial burden and physical and psychological morbidity for patients. This report presents a case of MRSA Periprosthetic joint infection in TKA with a two-stage exchange as a treatment.Case reportA 79-year-old woman had a painful, swollen knee with a sinus tract with purulent discharge at her left knee. The KSS Knee Score was 25, and the Function Score was 15. According to the findings, the patient was diagnosed with Periprosthetic Joint Infection by the Modified MSIS criteria and underwent a two-stage revision surgery with rifampicin and ciprofloxacin antibiotic administration.DiscussionPJI is a rare complication, with more than 50% of the cases caused by gram-positive cocci, Staphylococcus coagulase-negative, and Staphylococcus aureus. The treatment of PJI must be tailored according to the patient's clinical characteristics. Prosthesis exchange in one or two stages is the first choice of procedure.ConclusionTwo-stage revision surgery for knee PJI with dual antibiotics of rifampicin and ciprofloxacin is adequate to control infection and reinfection in a one-year follow-up.
Economic Burden of Periprosthetic Joint Infection Dicky Mulyadi
The Hip and Knee Journal Vol 4, No 1 (2023): February
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (414.075 KB) | DOI: 10.46355/hipknee.v4i1.150

Abstract

AbstractTotal knee arthroplasties (TKAs) and total hip arthroplasties (THAs) have been proven to help improving the quality of life of numerous patients and have been regarded as successful standard operations in orthopaedic surgeries. However, there is still a lingering devastating complication in the form of peri-prosthetic joint infection (PJI). This condition can be difficult to diagnose and may present at any time after arthroplasty requiring surgical intervention, often multiple times. Surgical revisions due to infection requires multiple visits and longer length of stay resulting in greater hospital costs. As the number of arthroplasty procedures increases so does the number of PJIs and therefore revisions. In 2010 there were estimated 8 136 PJI cases associated with hips and 17 781 cases associated with the knee and it is projected to grow in 2020 to be 16 584 cases for hip and 48 971 cases for knee. This also translated in the increase of estimated cost from around $785 million in 2010 to $1.62 billion in 2020.
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