J Korean Orthop Assoc.  2007 Dec;42(6):724-729. 10.4055/jkoa.2007.42.6.724.

Results of Treatment for Acute Deep Infected Total Knee Arthroplasty

Affiliations
  • 1Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea. Choi8422@yumc.yonsei.ac.kr

Abstract

PURPOSE: To evaluate the results of open or arthroscopic debridememt with a retention of the components for acute deep infected total knee arthroplasty.
MATERIALS AND METHODS
From January 1991 to December 2005, among 1282 patients, 1457 TKAs, 8 cases of acute deep infected total knee arthroplasty was retrospectively reviewd. A radiologic and clinical assessment were performed to analyze the treatment results. The mean age was 63.9 (57-77) years. One patient was male, and 7 were female.
RESULTS
The acute infection rate was 0.55% and the mean follow-up period was 41 months ( range, 30 months to 62 months). Using the Segawa classification, 3 cases were Type 2, and five cases were Type 3. Six cases were treated with arthroscopic debridement and antibiotic therapy. Two cases were treated with open debridement and antibiotic therapy. Intravenous antibiotic therapy was administered over a 3 week period. There were 2 cases of recurred infection. In synovial fluid culture, 4 cases were positive to S. aureus, 2 cases were positive to S. epidermidis and no bacteria was found in 2 cases. At the last follow-up, the mean Knee Society Score was 86.4 points. There were no chronic infection, loosening or osteolytic changes in the implants.
CONCLUSION
If an early diagnosis is made, open or arthroscopic debridememt with a retention of the components is a useful method for acute deep infected total knee arthroplasty.

Keyword

Knee; Total knee arthroplasty; Acute deep infection; Arthroscopic debridement; Open debridement

MeSH Terms

Arthroplasty*
Bacteria
Classification
Debridement
Early Diagnosis
Female
Follow-Up Studies
Humans
Knee*
Male
Retrospective Studies
Synovial Fluid

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