Table 2.
Management, followup, and control of infection in studied patients
| Patient number | Initial surgery | Reoperation (number) | Spacer antibiotic | Wound management | Followup (years) | AB for Enteroccocus PJI (side effect) | AB suppression | Infection controlled |
|---|---|---|---|---|---|---|---|---|
| 1 | I&D | Polyethylene/head exchange (1) | N/A | I&D, VAC | 5.7 | Vancomycin | − | Y (disability) |
| 2 | Two-stage exchange | Two-stage exchange (1) | Vancomycin, tobramycin | – | 6.7 | Linezolid | − | Y |
| 3 | Two-stage exchange | – | + (NR) | MF, SG | 1.5 | Vancomycin | − | Y |
| 4 | One-stage exchange | – | N/A | – | 1.6 | Linezolid | + | Y |
| 5 | Resection arthroplasty | Fusion, AKA (2) | N/A | I&D, MF, SG | 1.5 | Linezolid | − | AKA |
| 6 | Two-stage exchange | – | Vancomycin, tobramycin | MF, SG | 1.6 | Linezolid | + (Stevens- Johnson syndrome) | Persistent drainage from sinus tract (candidate for salvage surgery) |
| 7 | One-stage exchange | – | N/A | – | 2.1 | Vancomycin | − | Y |
| 8 | I&D | Resection arthroplasty (1) | N/A | 1.5 | Vancomycin (Clostridium difficile colitis) | − | Y | |
| 9 | Two-stage exchange | – | Vancomycin, tobramycin | – | 6 | Vancomycin | − | Y |
| 10 | Two-stage exchange | Resection arthroplasty (1) | Vancomycin, tobramycin | I&D | 1.5 | Daptomycin | − | Y |
| 11 | I&D | – | – | – | 1.5 | Ampicillin | − | Y |
| 12 | Two-stage exchange | – | Tobramycin | – | 6.3 | Linezolid | − | Y |
| 13† | Two-stage exchange | – | Vancomycin, tobramycin | – | 1.5 | NR* | − | Y |
| 14 | I&D | Two-stage exchange (1) | +(NR) | – | 2 | Vancomycin | − | Y |
| 15 | Two-stage exchange | Resection arthroplasty (1) | Vancomycin, tobramycin | – | 1.6 | Ampicillin, gentamicin | − | Y |
| 16 | Two-stage exchange | – | NR* | – | 2 | Vancomycin, ampicillin | − | Y |
| 17 | I&D | Cup revision (1) | N/A | – | 10.5 | Vancomycin | − | Y |
| 18 | Two-stage exchange | Spacer exchange (1) | Vancomycin, tobramycin | I&D, VAC, MF | 2 | Ertapenem, Vancomycin | + | Y |
| 19£ | Two-stage exchange | Spacer exchange (1) | NR* | – | 4.6 | Vancomycin, Linezolid | + | Y |
| 20 | Resection arthroplasty | – | – | – | 3.2 | Daptomycin | + | Y |
| 21 | Two-stage exchange | – | Vancomycin, tobramycin | – | 1.5 | Vancomycin | − | Y |
| 22 | One-stage exchange | – | – | – | 7.1 | Vancomycin | − | Y |
| 23 | One-stage exchange | – | – | – | 1.7 | Ampicillin, gentamicin | − | Y |
| 24 | Two-stage exchange | Spacer exchange, AKA (2) | Vancomycin, tobramycin | I&D, VAC, MF | 1.5 | Vancomycin | − | AKA |
| 25 | I&D | Resection arthroplasty (1) | N/A | Hematoma evacuation | 1.5 | Linezolid | + | Y |
| 26 | Two-stage exchange | – | Vancomycin, tobramycin | – | 1.8 | Vancomycin, gentamicin | − | Y |
| 27 | Two-stage exchange | Spacer exchange (1) | Tigecycline | – | 1.5 | NR§ | − | Y |
| 28 | I&D | I&D/cup revision (1) | N/A | – | 1.6 | Ampicillin, gentamicin | − | Y |
| 29 | One-stage exchange | I&D (1) | N/A | – | 2.8 | Daptomycin, metronidazole | + | Y |
| 30 | I&D | Twice pacer exchanges, resection (3) | Vancomycin, tobramycin | Multiple I&D, VAC, SG | 2.8 | Linezolid | + (renal failure) | Later PJI with coagulase-negative staphylococcus and Proteus |
| 31 | Two-stage (spacer exchanged) | Twice I&D, exchange of modular part (3) | + (NR) | MF, SG, VAC | 2.5 | Vancomycin, ertapenem | + | Later PJI with MRSA and Enterobacter |
| 32 | Two-stage exchange | I&D/liner exchange (1) | Vancomycin, tobramycin | I&D | 6.2 | Vancomycin, ampicillin | − | Later PJI with MRSA |
| 33 | I&D | – | N/A | – | 3.4 | Vancomycin | − | Y |
| 34 | One-stage exchange | – | N/A | – | 6 | Vancomycin | − | Later PJI with MRSA resulted in AKA |
| 35 | Two-stage exchange | Spacer exchanged (1) | Vancomycin, tobramycin | – | 1.9 | Vancomycin | − | Y |
| 36 | I&D | Two-stage, fusion (2) | Vancomycin, tobramycin | MF | 5.2 | Linezolid | − | Fusion |
* Name of antibiotic not mentioned in patient notes; †the reimplantation was not performed during the study period; AB = antibiotic; PJI = periprosthetic joint infection; I&D = irrigation and débridement; AKA = above-knee amputation; N/A = not applicable; NR = not reported; VAC = vacuum-assisted closure; MF = muscle flap; SG = skin graft; Y = yes; MRSA = methicillin-resistant Staphylococcus aureus.