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Related Experiment Videos

Infection after total knee arthroplasty.

A W Blom1, J Brown, A H Taylor

  • 1Avon Orthopaedic Centre, Southmead Hospital, Westbury-on-Trim, Bristol, England.

The Journal of Bone and Joint Surgery. British Volume
|July 28, 2004
PubMed
Summary

Infection rates after total knee arthroplasty (TKA) have decreased due to new protocols. However, the outcomes for patients who develop deep infections after TKA have shown minimal improvement.

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Area of Science:

  • Orthopedic Surgery
  • Infectious Disease Epidemiology

Background:

  • Previous audit in 1986 reported high infection rates: 4.4% for primary and 15% for revision total knee arthroplasty (TKA).
  • Implementation of enhanced prophylactic measures including antibiotic prophylaxis, sterile occlusive clothing, and chlorhexidine lavage.
  • Significant increase in the volume of TKA procedures performed since the initial audit.

Purpose of the Study:

  • To determine the current incidence and outcomes of infected total knee arthroplasty (TKA).
  • To compare current infection rates and outcomes with a previous audit from 1986.
  • To evaluate the impact of implemented prophylactic measures on TKA infection rates and patient outcomes.

Main Methods:

  • Prospective follow-up of 931 primary and 69 revision TKAs.

Related Experiment Videos

  • Patient tracing via postal questionnaire, telephone interview, and review of medical records.
  • Data collection on deep infection development and treatment outcomes.

    • Main Results:

    • Current deep infection rates are 1% for primary and 5.8% for revision TKA, a significant decrease from 1986.
    • For primary TKA infections, 22.2% were treated successfully without further surgery.
    • Outcomes for infected revision TKA were poor, including amputation, chronic discharging sinus, and arthrodesis, with comparable functional scores to two-stage revisions.

    Conclusions:

    • Stringent prophylactic measures have successfully reduced total knee arthroplasty (TKA) infection rates.
    • Despite reduced infection incidence, the outcomes for patients experiencing infected TKA, particularly revision cases, remain challenging.
    • Further strategies may be needed to improve the management and long-term outcomes of infected TKA.