J Korean Orthop Assoc.  2007 Apr;42(2):184-189. 10.4055/jkoa.2007.42.2.184.

Arthroscopic Treatment of Acutely Infected Total Knee Arthroplasty

Affiliations
  • 1Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hacw@smc.samsung.co.kr

Abstract

PURPOSE: This study is to evaluate the results of arthroscopic treatment for an acutely infected total knee arthroplasty (TKA) and to determine the protocol for a successful arthroscopic treatment. MATERIALS AND METHODS: Of 16 cases of acutely infected TKA treated at this institution, 7 cases treated with arthroscopic debridement were retrospectively reviewed. The indication for arthroscopic debridement was patients with a radiographically stable prosthesis and within 72 hours of the onset of symptoms. The necessity and method of the secondary procedures were determined using a follow up of the C-reactve protein (CRP) test and physical examination after the primary arthroscopic debridment. Successful treatment was defined as no recurrence or no re-operation by the final follow-up. RESULTS: All 7 cases were treated with a retention of the prosthesis. 3 cases were treated successfully with primary arthroscopic debridement only. Three cases were treated with open debridement after primary arthroscopic debridement. One case was treated with repeated arthroscopic debridement after primary arthroscopic debridement. CONCLUSION: Arthroscopic debridement is an effective treatment option for an acutely infected TKA within 72 hours of the onset of symptoms. A careful CRP follow up is suggested as the critical index to determine the secondary procedure for successful treatment of an acutely infected TKA by arthroscopic debridement.

Keyword

Knee; Total knee arthroplasty; Acutely deep infection; Arthroscopic debridement

Reference

1. Dixon P, Parish EN, Cross MJ. Arthroscopic debridement in the treatment of the infected total knee replacement. J Bone Joint Surg Br. 2004. 86:39–42.
Article
2. England SP, Stern SH, Insall JN, Windsor RE. Total knee arthroplasty in diabetes mellitus. Clin Orthop Relat Res. 1990. 260:130–134.
Article
3. Flood JN, Kolarik DB. Arthroscopic irrigation and debridement of infected total knee arthroplasty: report of two cases. Arthroscopy. 1988. 4:182–186.
Article
4. Hartman MB, Fehring TK, Jordan L, Norton HJ. Periprosthetic knee sepsis. The role of irrigation and debridement. Clin Orthop Relat Res. 1991. 273:113–118.
5. Ilahi OA, Al-Habbal GA, Bocell JR, Tullos HS, Huo MH. Arthroscopic debridement of acute periprosthetic septic arthritis of the knee. Arthropscopy. 2005. 21:303–306.
Article
6. Mont MA, Waldman B, Banerjee C, Pacheco IH, Hungerford DS. Multiple irrigation, debridement, and retention of components in infected total knee arthroplasty. J Arthroplasty. 1997. 12:426–433.
Article
7. Munjal S, Phillips MJ, Krackow KA. Revision total knee arthroplasty: planning, controversies, and management-infection. Instr Course Lect. 2001. 50:367–377.
8. Petty W, Bryan RS, Coventry MB, Peterson LF. Infection after total knee arthroplasty. Orthop Clin North Am. 1975. 6:1005–1014.
Article
9. Rand JA. Alternatives to reimplantation for salvage of the total knee arthroplasty complicated by infection. J Bone Joint Surg Am. 1993. 75:282–289.
Article
10. Tannenbaum DA, Matthews LS, Grady-Benson JC. Infection around joint replacements in patients who have a renal or liver transplantation. J Bone Joint Surg Am. 1997. 79:36–43.
Article
11. Waldman BJ, Hostin E, Mont MA, Hungerford DS. Infected total knee arthroplasty treated by arthroscopic irrigation and debridement. J Arthroplasty. 2000. 15:430–436.
Full Text Links
  • JKOA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr