• BACKGROUND
    • The optimal postoperative antibiotic duration has not been determined for aseptic revision total knee arthroplasty (R-TKA) where the risk of periprosthetic joint infection (PJI) is 3%-7.5%. This study compared PJI rates in aseptic R-TKA performed with extended oral antibiotic prophylaxis (EOAP) to published rates.
  • METHODS
    • Aseptic R-TKAs consecutively performed between 2013 and 2017 at a tertiary care referral center in the American Midwest were retrospectively reviewed. All patients were administered intravenous antibiotics while hospitalized and discharged on 7-day oral antibiotic prophylaxis. Infection rates and antibiotic-related complications were assessed.
  • RESULTS
    • Sixty-seven percent of the 176 analysis patients were female, with an average age of 64 years and body mass index of 35 kg/m2. Instability and aseptic loosening comprised 86% of revision diagnoses. Overall, 87.5% of intraoperative cultures were negative, and the remainder were single positive cultures considered contaminants. PJI rates were 0% at 90 days, 1.8% (95% confidence interval 0.4%-5.3%) at 1 year, and 2.2% (95% confidence interval 0.6%-5.7%) at mean follow-up of approximately 3 years (range, 7-65 months).
  • CONCLUSION
    • EOAP after aseptic R-TKA resulted in a PJI rate equivalent to primary TKA, representing a 2- to-4-fold decrease compared with published aseptic R-TKA infection rates. Further study on the benefits and costs of EOAP after aseptic R-TKA is encouraged.