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Open Debridement and Polyethylene Exchange (ODPE) in the Infected Total Knee Arthroplasty

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The Infected Total Knee Arthroplasty

Abstract

Of the methods used for the treatment of periprosthetic joint infections (PJIs), open debridement and polyethylene exchange (ODPE) is technically the least demanding, the most economical, and with lower morbidity in comparison with one- or two-stage revision arthroplasty. However, the failure rate of ODPE can be high and can compromise outcomes of the two-stage revision. ODPE has been recommended as a treatment for PJI in patients with an early (<4 weeks) postoperative infection or an acute hematogenous infection if the duration of clinical signs and symptoms is less than 3 weeks. ODPE should not be recommended in chronic infection (>4 weeks postoperatively, insidious onset of symptoms). ODPE is indicated in patients who have a well-fixed prosthesis and local soft tissues in good condition (no abscess or sinus tract). ODPE has shown to be particularly effective in PJIs caused by low-virulence organisms. ODPE can be a good option in elderly patients with less bone stock and multiple comorbidities, for whom anesthesia and more invasive/complex surgery could be dangerous. ODPE has been shown to be effective in non-immunocompromised patients. Arthroscopic irrigation and debridement have inferior results as compared with open debridement.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, “La Paz” University Hospital-IdiPaz, Paseo de la Castellana 261, 28046, Madrid, Spain

    Carlos A. Encinas-Ullán, Ángel Martínez-Lloreda & E. Carlos Rodríguez-Merchán

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  1. Carlos A. Encinas-Ullán
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  2. Ángel Martínez-Lloreda
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  3. E. Carlos Rodríguez-Merchán
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Correspondence to E. Carlos Rodríguez-Merchán .

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Editors and Affiliations

  1. Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain

    E. Carlos Rodríguez-Merchán

  2. University College London Hospitals , London, United Kingdom

    Sam Oussedik

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Encinas-Ullán, C.A., Martínez-Lloreda, Á., Rodríguez-Merchán, E.C. (2018). Open Debridement and Polyethylene Exchange (ODPE) in the Infected Total Knee Arthroplasty. In: Rodríguez-Merchán, E., Oussedik, S. (eds) The Infected Total Knee Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-66730-0_17

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  • DOI: https://doi.org/10.1007/978-3-319-66730-0_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66729-4

  • Online ISBN: 978-3-319-66730-0

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