Introduction

Peri-prosthetic infections due to P. acnes may present as Prosthesis dysfunction without any obvious sepsis. We present our experience of efficient management of total knee prosthesis infection secondary to P. acnes which is one of the biggest case series.

Aim: The purpose of this study is to evaluate the long term results of modified Elmslie-Trillat procedure. We have also reviewed the various modifications and its outcome seen in the literature to the original conventional Elmslie-Trillat procedure. Our modified surgical technique is described.

Materials and Methods: The patients were evaluated functionally using Kujala and Fulkerson scoring system. Clinical examination was performed to look for patella apprehension, tracking of patella, crepitus and range of movement. X rays were done to look for degenerative changes. The primary end point in our study was evidence of recurrent instability and the secondary end point was functional scoring and evidence of degenerative changes.

Results: Out of 38 patients and 42 knees available from our records from 1991 to 2005, 16 patients and 20 knees were available for functional and clinical review. The mean age at operation was 27 years. The average follow up was 9 years. 74% of the knees scored excellent to good with kujala and Fulkerson scoring. There was no episode of recurrent dislocation post-operatively in our series. Minimal degenerative changes were noted in 15% of knees. 37% of knees needed removal of screw. 58% of knee had some numbness around the scar. 80% of them returned back to original occupation. 60% of them went back to original sporting levels. All patients felt happy to recommend the operation.

Conclusion: We conclude that our modified Elmslie-Trillat surgical procedure is very successful in eliminating recurrent patellar dislocation and instability. We present the literature available on the various modifications of Elmslie-Trillat procedure and its outcome.