Management of total knee arthroplasty infection

The treatment of infected total knee arthroplasty represents the most difficult form of revision surgery. Successful salvage of this complication can be accomplished only by extensive investment of surgical and infectious disease efforts in eradicating the infection. A two-stage reimplantation procedure for treating this condition has been the most successful functional option and should be utilized whenever possible to definitively eradicate the infection and ensure good function of the knee joint. It is the procedure of choice for younger healthy patients who can medically tolerate the protocol. Other options may be necessary as the medical condition of the patient dictates. Initial debridement with antibiotic suppression and antibiotic suppression alone have yielded limited successful results but can be accomplished only in a small number (23%) of patients.