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Superficial wound infection occurred in 9 cases (11%).12 cases (14%) required further surgery: washout of a superficial infection (n=4), re-revisionprocedures (n=4), 2 nd stage revision for infection (n=2), washout for deep infection (n=2).Mortality at 3 months was 19%, 1 year (25%), 3 years (40%) and 5 years (49%; THR 37%;Hemi 72%; Fisher’s Exact Test p=0.003).This study has revealed that high rates of union can be achieved through the treatment ofperiprosthetic fractures around loose implants using revision prostheses. Implant choice dependsupon the fracture configuration and available bone stock.Poster: 82Principles of Revision Total Knee Arthroplasty*Ashok Rajgopal - Fortis Hospital,New Delhi - New Delhi, India*Email: arajgopal@hotmail.comWith the increase in the numbers of total knee arthroplasty (TKA) there are bound to beincrease in revision surgeries. In this paper we enumerate the principles of revision. The mostimportant principle on which depends the success of surgery is determining the cause of failure.Secondly one must dispense with the practice of single component revision surgeries. When animplant fails it invariably is due to a contribution of all the components. A thorough clinicalexamination and laboratory and radiological investigation must be performed in the run up tothe surgery and infection must be ruled out or confirmed. Infected TKA are presently treated bytwo stage revision protocol. In the first stage the implant and all devitalized tissue are removedand an antibiotic impregnated cement spacer is put in. intra-venous antibiotics are prescribedfor a period of 6 weeks and when the ESR and CRP levels are within normal levels the secondstage is performed. The intra-operative technique in both types of revision surgery remainslargely the same. Meticulous pre-operative planning, templating and making available all theimplant options in the operating room go a long way in ensuring success of this difficultprocedure. Intra-operatively establishing the tibial plateau is the first step. A tibial stem ispreferred. Care must be taken to re-establish the original joint line at this stage. The femur isthen sized and a decision is taken regarding the use of constrained or non-constrained options atthis stage. This decision is based on the status of the ligaments in the knee namely the medialand lateral collateral ligament. A non – constrained option is indicated when the medial andlateral collateral ligaments are intact. A constrained condylar type of knee may be used if themedial collateral ligament is compromised. In case of poly-ligamentous instability a rotatinghinge type of implant may be needed. Adequate component sizing and proper implant selectionwill give us a stable knee joint which will function well in the long term.file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]