Negative impact of prior debridement on functional outcome of subsequent two-stage revision for early knee periprosthetic infection

Purpose To compare the functional outcome of two-stage revision (2SR) in patients without a prior debridement, antibiotics and implant retention with those patients who underwent 2SR after a failed debridement, antibiotics and implant retention for early periprosthetic joint infection following total knee arthroplasty (TKA). Negative impact of prior failed debridement, antibiotics and implant retention on the functional outcome of subsequent 2SR was hypothesized. Methods Case–control study of 49 patients initially treated with 2SR (group A) and 43 treated with 2SR after a prior failed debridement, antibiotics and implant retention (group B). Functional outcome was assessed by the Knee Society Scores (KSS) and Western Ontario and McMaster Universities (WOMAC) questionnaire. Range of motion (ROM) of the knee was also measured. Results The median follow-up was 4.1 (range 3–7) years. At final follow-up, KSS-knee ( p = 0.001), KSS-function ( p = 0.002), WOMAC-function ( p = 0.022) and ROM ( p = 0.002) were significantly better in the group A as compared to the group B. There was no significant difference between groups in the WOMAC-pain score ( p = 0.597). In multivariate analysis, BMI