(P 105) TREATMENT SUCCESS RATE AFTER SURGICAL MANAGEMENT OF PERIPROSTHETIC JOINT INFECTIONS IN ONCOLOGIC PROXIMAL TIBIA RECONSTRUCTION

Objective: Periprosthetic joint infection (PJI) is a devastating complication following oncologic proximal tibia reconstruction (PTR), yet optimal management remains unclear. We aimed to assess treatment success and functional outcomes of different surgical strategies for PTR PJI.

Methods: We retrospectively reviewed patients with PTR PJI treated between 1995–2023 at two tertiary centers. Surgical approaches included DAIR (debridement, antibiotics, and implant retention), DAIR plus (with modular component exchange), and two-stage revision. Reinfection-free survival (RFS) and amputation-free survival were analyzed using Kaplan-Meier methods. Functional outcome (MSTS) and quality of life (EQ index) were assessed at last follow-up.

Results: Six-month RFS was 22% (DAIR), 67% (DAIR plus), and 83% (two-stage) (p=0.002). At two years, DAIR plus and two-stage had significantly higher RFS than DAIR (p < 0.001), with no difference between DAIR plus and two-stage. Amputation-free survival at two years was 86% (two-stage), 58% (DAIR plus), and 44% (DAIR) (p=0.36). Median MSTS was 63%, with no significant difference across groups (p=0.92). Median EQ index was 68.4, also without significant differences (p=0.69).

Conclusion: DAIR plus achieved comparable infection control to two-stage revision and may be considered in selected patients with well-fixed stems. Functional outcomes following PTR PJI remain modest, underscoring the need for prospective data to assess the functional impact of different surgical strategies.