{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:54:48Z","timestamp":1787496888669,"version":"build-2736575974"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum M\u00fcnster"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>We investigated the time to reimplantation (TTR) during two-stage revision using static spacers with regard to treatment success and function in patients with chronic periprosthetic joint infection (PJI) of the knee.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>163 patients (median age 72\u00a0years, 72 women) who underwent two-stage exchange for chronic knee PJI between 2012 and 2020 were retrospectively analyzed (based on the 2011 Musculoskeletal Infection Society criteria). A cutoff TTR for increased risk of reinfection was identified using the maximally selected log-rank statistic. Infection control, aseptic revisions and overall survival were analyzed using Kaplan\u2013Meier survival estimates. Adjustment for confounding factors\u2014the Charlson Comorbidity Index (CCI) and C-reactive protein (CRP)\u2014was done with a Cox proportional hazards model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      When TTR exceeded 94\u00a0days, the adjusted hazard of reinfection was increased 2.8-fold (95% CI 1.4\u20135.7;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0036). The reinfection-free rate was 67% (95% CI 52-79%) after 2\u00a0years and 33% (95% CI 11\u201357%) after 5\u00a0years for a longer TTR compared to 89% (95% CI 81\u201394%) and 80% (95% CI 69\u201387%) at 2 and 5\u00a0years, respectively, for a shorter TTR. Adjusted overall survival and number of aseptic revisions did not differ between the longer TTR and shorter TTR groups. Maximum knee flexion was 90\u00b0 (IQR 84\u2013100) for a longer TTR and 95\u00b0 (IQR 90\u2013100) for a shorter TTR (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0431), with no difference between the groups in Oxford Knee Score. Baseline characteristics were similar (body mass index, age, previous surgeries, microorganisms) for the two groups, except that there was a higher CCI (median 4 vs. 3) and higher CRP (median 3.7 vs 2.6\u00a0mg\/dl) in the longer TTR group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A long TTR is sometimes unavoidable in clinical practice, but surgeons should be aware of a potentially higher risk of reinfection.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Level of evidence<\/jats:italic>\n                      : III, retrospective comparative study.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s10195-024-00745-7","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T13:02:30Z","timestamp":1711371750000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Evaluation of time to reimplantation as a risk factor in two-stage revision with static spacers for periprosthetic knee joint infection"],"prefix":"10.1186","volume":"25","author":[{"given":"Jan","family":"Puetzler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Hofschneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Gosheger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Theil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Schulze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Schwarze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Koch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burkhard","family":"Moellenbeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"issue":"9","key":"745_CR1","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1016\/j.arth.2015.03.035","volume":"30","author":"AF Kamath","year":"2015","unstructured":"Kamath AF et al (2015) Quantifying the burden of revision total joint arthroplasty for periprosthetic infection. 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Consent to participate was not deemed necessary as the data were analyzed retrospectively.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent for publication was not deemed necessary as the manuscript does not contain individual data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"15"}}