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KMID : 0359620090210020098
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Journal of Korean Knee Society
2009 Volume.21 No. 2 p.98 ~ p.104
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Treatment of Candida Infection after TKA
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Park Bong-Ju
Kim Ju-O
Kim Sul-Jeon
Chang Ji-Hoon
Yang Yun-Hyeok
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Abstract
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Purpose: We wanted to review the clinical results of staged reimplantation in patients who had candidal infection after total knee arthroplasty.
Materials and Methods: We reviewed five patients who had a candidal prosthetic knee infection, as was assessed by synovial fluid culture. Amphotericin B was intravenously administrated to all five patients during the postoperative period for six weeks and followed for at least twelve months. We carried out two-stage re-implantations with using antifungal agent-impregnated bone cement. Whether or not infection recurred was evaluated according to the symptoms and radiologic and hematologic studies. The clinical results were analyzed on the basis of the range of motion and hospital for special surgery (HSS) score.
Results: The final review showed that all of the symptoms disappeared. We could not find any loosening on the radiologic studies and all five patients had normal C-reactive protein values on serological exams. The mean postoperative range of motion was 1o (range: 0∼5)∼99o (range: 70∼130) and the mean HSS score improved from 49.4 (range: 44∼64) points to 73 (range: 65∼90) after the re-implantation.
Conclusion: We successfully controlled five candidal prosthetic knee infections by removing the components
in conjunction with using an antifungal- impregnated bone cement and staged re-implantation after a 6 week course of intravenous antifungal drugs.
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KEYWORD
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Total knee arthroplasty, Candida infection, Staged revision
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