Metal Artifact Reduction Sequence MRI for Surgical Decision-Making in Infected Unicompartmental Knee Arthroplasty

NCT07208968 | Completed

• 1 other identifier: MTCA,ECFAH Of FMU [2015]084 -1
• Study Type: observational
• Target: 28
• Locations: 1 country
• Sites: 1

Brief Summary

A single-center retrospective cohort study was conducted in the Department of Orthopedics of Fujian Medical University Affiliated First Hospital. This study reviewed 28 patients who received unicompartmental prosthetic joint infection (uPJI) treatment at this institution from 2017 to 2023. The personal information of the patients, including age, gender, affected side, age-adjusted Charles Syndrome Index (aCCI), inflammation markers, lesion range on magnetic resonance angiography (MARS-MRI), lesion range observed directly during surgery and surgical methods, were recorded in detail. The study evaluated the clinical decision-making of a standardized MARS-MRI-guided treatment protocol for uPJI by reviewing the clinical outcomes of uPJI patients in a single PJI center.

Conditions

Prosthetic Joint Infection; Unicompartmental Knee Arthroplasty

Keywords

Prosthetic joint infection; Unicompartmental knee arthroplasty; Antibiotics and implant retention; One-stage revision; Unicompartmental spacer; Metal artefact reduction sequence magnetic resonance imaging

Outcome Measures

Primary Outcomes (2)

• Infection control or not according to the MSIS criteria

  According to the Musculoskeletal Infection Society (MSIS) criteria, infection control was defined as no local inflammation, infection/aseptic revision, or uPJI-related death within 1 year of the initial surgery.

  preoperative and two-year follow-up

• The Hospital for Special Surgery Knee Score (HSS) score

  The Hospital for Special Surgery Knee Score (HSS) is a patient-reported questionnaire specific to the knee joint, with a total score of 100 points. It comprises six scoring components: pain (30 points), function (22 points), range of motion (18 points), muscle strength (10 points), knee deformity (10 points) and stability (10 points). Additional points are deducted for the use of assistive devices, extension lag and varus deformity: up to 3 points for assistive device use, up to 5 points for extension lag and 1 point deducted for every 5 degrees of varus deformity. The scores are classified as follows: ≥ 85 as "Excellent", 70-84 as "Good", 60-69 as "Fair", and \< 60 as "Poor". The HSS score is widely praised for its perceived ease of use and quick recording and has been shown to be an effective and reliable measure for assessing the efficacy of TKA.

  preoperative and two-year follow-up

Secondary Outcomes (4)

• Range of motion

  preoperative and two-year follow-up

• Visual Analogue Scale (VAS) score

  preoperative and two-year follow-up

• Pathogens Type

  preoperative and two-year follow-up

• SF-12 score

  preoperative and two-year follow-up

Study Arms (2)

DAIR group

Patients with acute/hematogenous uPJI underwent debridement, antibiotics and implant retention (DAIR)

Revision group

Patients with chronic uPJI underwent revision.

Eligibility Criteria

• Age: 18 Years - 90 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Twenty-seven patients (28 knees) diagnosed with uPJI from 2017 to 2024 were analyzed. MARS-MRI and intraoperative direct vision were used to confirm the extent of lesions. All patients completed at least one year of follow-up. Follow-up comprised comprehensive orthopaedic examinations and serological tests, supplemented by repeat imaging where necessary to assess local fracture/internal fixation status.

You may qualify if:

• Diagnosis of uPJI on the basis of medical history, symptoms, imaging data, etc.;
• Treatment by internal fixation surgery;
• Normal cognitive function;
• Informed consent obtained from the patient or family.

You may not qualify if:

• Significant missing data: In accordance with the Transparent Reporting of a Multivariate Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) statement, only cases with complete key variables (missing rate \<5%) were included;
• Severe preoperative systemic comorbidities (e.g., decompensated liver/renal failure, active pneumonia, malignancy, and cachexia) and/or a history of mental illness;
• Missing postoperative follow-up.

Sponsors & Collaborators

• First Affiliated Hospital of Fujian Medical University: lead

Study Sites (1)

The First Affiliated Hospital of Fujian Medical University

Fuzhou, Fujian, 350005, China

Location

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Deputy chief physician

Study Record Dates

• First Submitted: September 21, 2025
• First Posted: October 6, 2025
• Study Start: June 1, 2017
• Primary Completion: June 30, 2023
• Study Completion: June 30, 2023
• Last Updated: October 6, 2025

Record last verified: 2025-09

Locations

CN (1)