The infected total knee arthroplasty: just when you thought it was over

Of the various options available for infected total knee arthroplasties (TKAs), a successful primary-exchange revision technique offers decreased morbidity for the patient by eliminating a second major surgery and associated hospitalization, and substantially reduces the cost associated with this dreaded condition. In 22 infected TKAs treated by a 1-stage revision and followed for an average of 10.2 years (range, 1.4-19.6 years), 90.9% were free of recurrent infection. Knee scores averaged 79.5, with 85.7% good or excellent results. The physiologic classification of the host appeared to influence the outcome of revision. All patients in class A or B (20 knees) had successful eradication of their primary infection after 1-stage revision; 2 physiologic class C patients developed early failure secondary to poor wound healing.