Infection after arthroscopic treatment of symptomatic total knee arthroplasty

Arthroscopy for failed total knee arthroplasty (TKA) is a well-documented and accepted procedure for diagnosis of component and soft tissue problems. Fortunately, infection is a rare complication of arthroscopy. To our knowledge, we present the second report of acutely infected TKA after arthroscopy. Two days after arthroscopic treatment because of painful TKA, a 72-year-old woman developed an acutely infected TKA. The patient underwent immediate arthroscopic irrigation and debridement, and treatment with intravenous antibiotics. The cultures from knee joint aspirates were positive for infection with the organism Staphylococcus aureus. Three days later, repeat open debridement with exchange of the tibial polyethylene insert was performed because of persistent fever and fluctuation. The patient was treated with antibiotics for 6 weeks postoperatively. At the latest follow-up evaluation, 26 months after revision, the patient was pain free, had full activities of daily living, and had no clinical or radiographic signs of infection. However, despite the success of arthroscopy in treating and evaluating painful TKA, this potential complication should be considered when performing arthroscopy of symptomatic TKA.