Infected total knee arthroplasty: diagnosis and treatment

Infection following total knee arthroplasty is a challenging complication for both the patient and the surgeon. Precautions to prevent infection include the use of prophylactic antibiotics, minimized surgical time, and meticulous surgical technique. A patient's risk factors should be thoroughly assessed and medical comorbidities should be treated before surgery. When infection is suspected, prompt evaluation of the patient is necessary. The management of a TKA infection is dictated by the duration of symptoms, suspicion for infection, time since index surgery, the patient's willingness and medical capability for undergoing multiple surgeries, the bacteria's sensitivity to antibiotics, and the surgeon's ability to perform complex surgery. Acute infections are treated with aggressive débridement and parenteral antibiotics. In appropriate circumstances, chronic infections are best treated with two-stage reimplantation, which can reliably eradicate infection, relieve pain, and restore good function.