{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T19:23:52Z","timestamp":1762543432486,"version":"3.37.3"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To our knowledge, no studies have compared postoperative outcomes between patients who received a temporary short or long intramedullary (IM) nail in the setting of infected total knee arthroplasty (TKA). Therefore, the aim of this study was to compare short-term outcomes for patients who underwent long or short IM nail insertion for treatment of periprosthetic knee infection. Specifically, we compared: (1) success rates; (2) patient reported\/functional outcomes; and (3) complications between patients implanted with a short or a long IM nail following PJI of the knee. A retrospective chart review was performed for patients who underwent two-stage exchange arthroplasty with a temporary long or short IM nail between November 2010 and June 2018 at our institution (n\u2009=\u200967). Continuous and categorical variables were assessed using t-test\/Mann\u2013Whitney U test and chi-squared test, respectively. Logistic regression analyses were conducted to assess the effect of IM nail length on success rate while adjusting for age, sex, body mass index, and race. A total of 36 patients underwent temporary treatment with a long IM nail, while 31 patients received a short IM nail. There were no differences in success rate for reimplanted patients treated with long and short IM nails (odds ratio 0.992; p\u2009=\u20090.847). Fewer patients with a long IM nail went on to reimplantation (52.8 vs. 83.9%; p\u2009=\u20090.007). There was no difference in satisfaction (7.86 vs. 7.68; p\u2009=\u20090.515), pain scores (3.39 vs. 4.45 points; p\u2009=\u20090.126), or Knee Society score outcome scores (150.61 vs. 166.26 points; p\u2009=\u20090.117) between long or short IM nail patients. Following reimplantation, there was no difference in the number of patients who became reinfected (15.8 vs. 11.5%; p\u2009=\u20090.679) or went on to amputation (0 vs. 7.7%; p\u2009=\u20090.210). Periprosthetic joint infection (PJI) is a rare but serious postoperative complication following TKA. Our findings suggest that the use of long and short IM nails during two-stage exchange can have equal utility in PJI patients with severe bone defects.<\/jats:p>","DOI":"10.1055\/s-0041-1729552","type":"journal-article","created":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T22:50:58Z","timestamp":1620168658000},"page":"039-046","source":"Crossref","is-referenced-by-count":1,"title":["Treatment of Periprosthetic Joint Infection in Total Knee Arthroplasty with a Temporary Intramedullary Nail: Is a Long or Short Nail Better?"],"prefix":"10.1055","volume":"36","author":[{"given":"Nequesha S.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iciar M. Davila","family":"Castrodad","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hackensack Meridian School of Medicine, Seton Hall University, Nutley, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer I.","family":"Etcheson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret N.","family":"Kelemen","sequence":"additional","affiliation":[{"name":"Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. Johannes","family":"Plate","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5694-3081","authenticated-orcid":false,"given":"Janet D.","family":"Conway","sequence":"additional","affiliation":[{"name":"Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5651-2625","authenticated-orcid":false,"given":"Ronald E.","family":"Delanois","sequence":"additional","affiliation":[{"name":"Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,5,4]]},"reference":[{"issue":"392","key":"ref1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/00003086-200111000-00003","article-title":"Infection in total knee replacement: a retrospective review of 6489 total knee replacements","author":"G Peersman","year":"2001","journal-title":"Clin Orthop Relat Res"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1302\/0301-620X.88B7.17150","article-title":"The incidence of deep prosthetic infections in a specialist orthopaedic hospital: a 15-year prospective survey","volume":"88","author":"J E Phillips","year":"2006","journal-title":"J Bone Joint Surg Br"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1007\/s11999-008-0209-4","article-title":"Periprosthetic joint infection: the incidence, timing, and predisposing factors","volume":"466","author":"L Pulido","year":"2008","journal-title":"Clin Orthop Relat Res"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.arth.2013.07.041","article-title":"Systematic review comparing static and articulating spacers used for revision of infected total knee arthroplasty","volume":"29","author":"R Pivec","year":"2014","journal-title":"J Arthroplasty"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.knee.2014.10.005","article-title":"Outcomes of infected revision knee arthroplasty managed by two-stage revision in a tertiary referral centre","volume":"22","author":"J Stammers","year":"2015","journal-title":"Knee"},{"issue":"08","key":"ref6","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1007\/s11999-010-1308-6","article-title":"Revision total knee arthroplasty infection: incidence and predictors","volume":"468","author":"S MJ Mortazavi","year":"2010","journal-title":"Clin Orthop Relat Res"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"180","DOI":"10.4055\/cios.2013.5.3.180","article-title":"Revision of infected total knee arthroplasty: two-stage reimplantation using an antibiotic-impregnated static spacer","volume":"5","author":"A Silvestre","year":"2013","journal-title":"Clin Orthop Surg"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.knee.2012.06.004","article-title":"Two-stage reimplantation for periprosthetic knee infection: influence of host health status and infecting microorganism","volume":"20","author":"D Tigani","year":"2013","journal-title":"Knee"},{"key":"ref9","first-page":"148","article-title":"Bone loss associated with the use of spacer blocks in infected total knee arthroplasty","volume":"LLC","author":"T F Calton","year":"1997","journal-title":"Clin. Orthop. Relat. Res."},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"19","DOI":"10.2106\/JBJS.16.00075","article-title":"Repeat two-stage exchange arthroplasty for periprosthetic knee infection is dependent on host grade","volume":"99","author":"K A Fehring","year":"2017","journal-title":"J Bone Joint Surg Am"},{"issue":"12","key":"ref11","doi-asserted-by":"crossref","first-page":"2445","DOI":"10.1007\/s00167-012-1885-x","article-title":"Two-stage revision of septic knee prosthesis with articulating knee spacers yields better infection eradication rate than one-stage or two-stage revision with static spacers","volume":"20","author":"C L Roman\u00f2","year":"2012","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1007\/s11999-011-2095-4","article-title":"Minimizing dynamic knee spacer complications in infected revision arthroplasty","volume":"470","author":"A J Johnson","year":"2012","journal-title":"Clin Orthop Relat Res"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s12178-015-9293-8","article-title":"The use of spacers (static and mobile) in infection knee arthroplasty","volume":"8","author":"L Mazzucchelli","year":"2015","journal-title":"Curr Rev Musculoskelet Med"},{"issue":"08","key":"ref14","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s00264-009-0907-x","article-title":"Comparison of static and mobile antibiotic-impregnated cement spacers for the treatment of infected total knee arthroplasty","volume":"34","author":"S-J Park","year":"2010","journal-title":"Int Orthop"},{"issue":"07","key":"ref15","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1016\/j.arth.2007.04.028","article-title":"Antibiotic-loaded cement articulating spacer for 2-stage reimplantation in infected total knee arthroplasty: a simple and economic method","volume":"22","author":"Y C Hsu","year":"2007","journal-title":"J Arthroplasty"},{"issue":"380","key":"ref16","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1097\/00003086-200011000-00003","article-title":"Articulating versus static spacers in revision total knee arthroplasty for sepsis. 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Surgical technique","volume":"89","author":"K Bargiotas","year":"2007","journal-title":"J Bone Joint Surg Am"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1708856","article-title":"Two-stage exchange using a short intramedullary nail for treatment of periprosthetic knee infections: a technique worth questioning","author":"N S Mohamed","year":"2020","journal-title":"J Knee Surg"},{"issue":"05","key":"ref23","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1016\/j.knee.2017.05.019","article-title":"Two-stage knee arthrodesis with a modular intramedullary nail due to septic failure of revision total knee arthroplasty with extensor mechanism deficiency","volume":"24","author":"M J Friedrich","year":"2017","journal-title":"Knee"},{"issue":"10","key":"ref24","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1007\/s00402-018-3007-9","article-title":"Comparison of two-stage revision arthroplasty and intramedullary arthrodesis in patients with failed infected knee arthroplasty","volume":"138","author":"M Gathen","year":"2018","journal-title":"Arch Orthop Trauma Surg"},{"issue":"02","key":"ref25","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1177\/230949901101900223","article-title":"Review article: bone defect classifications in revision total knee arthroplasty","volume":"19","author":"Y Y Qiu","year":"2011","journal-title":"J Orthop Surg (Hong Kong)"},{"issue":"403","key":"ref26","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00003086-200210000-00003","article-title":"Periprosthetic total hip infection: outcomes using a staging system","author":"E J McPherson","year":"2002","journal-title":"Clin Orthop Relat Res"},{"issue":"07","key":"ref27","doi-asserted-by":"crossref","first-page":"2374","DOI":"10.1007\/s11999-013-2866-1","article-title":"Success after treatment of periprosthetic joint infection: a Delphi-based international multidisciplinary consensus","volume":"471","author":"C Diaz-Ledezma","year":"2013","journal-title":"Clin Orthop Relat Res"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s00264-011-1267-x","article-title":"Reinfection after two-stage revision for periprosthetic infection of total knee arthroplasty","volume":"36","author":"B Kubista","year":"2012","journal-title":"Int Orthop"},{"issue":"08","key":"ref29","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1016\/j.arth.2012.02.023","article-title":"Are prosthetic spacers safe to use in 2-stage treatment for infected total knee arthroplasty?","volume":"27","author":"H-R Choi","year":"2012","journal-title":"J Arthroplasty"},{"issue":"01","key":"ref30","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1007\/s11999-015-4443-2","article-title":"Treatment of periprosthetic knee infection with a two-stage protocol using static spacers","volume":"474","author":"P Lichstein","year":"2016","journal-title":"Clin Orthop Relat Res"},{"issue":"08","key":"ref31","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1016\/j.arth.2007.04.009","article-title":"Functional advantage of articulating versus static spacers in 2-stage revision for total knee arthroplasty infection","volume":"22","author":"M G Freeman","year":"2007","journal-title":"J Arthroplasty"},{"issue":"04","key":"ref32","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1007\/s00264-006-0102-2","article-title":"Spacer prostheses in two-stage revision of infected knee arthroplasty","volume":"30","author":"E J\u00e4msen","year":"2006","journal-title":"Int Orthop"}],"container-title":["The Journal of Knee Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1729552.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:28:20Z","timestamp":1672273700000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1729552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,4]]},"references-count":32,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2022,12,28]]},"published-print":{"date-parts":[[2023,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1729552","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1538-8506","1938-2480"],"issn-type":[{"type":"print","value":"1538-8506"},{"type":"electronic","value":"1938-2480"}],"subject":[],"published":{"date-parts":[[2021,5,4]]}}}