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Related Experiment Videos

Excision arthroplasty for infected constrained total knee replacements.

A W Lettin1, M J Neil, N D Citron

  • 1St. Bartholomew's Hospital, West Smithfield, London, England.

The Journal of Bone and Joint Surgery. British Volume
|March 1, 1990
PubMed
Summary

This study shows that removing infected knee replacements, followed by debridement and antibiotics, successfully eradicates infection. Patients retained functioning limbs, avoiding amputation or fusion, though some experienced residual pain.

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Area of Science:

  • Orthopedic Surgery
  • Infectious Disease Management

Background:

  • Periprosthetic joint infection (PJI) following total knee replacement (TKR) presents a significant clinical challenge.
  • Management options for infected TKR often include revision arthroplasty, arthrodesis, or amputation.

Purpose of the Study:

  • To evaluate the efficacy of a specific treatment protocol for persistent and disabling infections after total knee replacement.
  • To assess limb function and infection eradication rates in patients undergoing prosthesis removal and debridement.

Main Methods:

  • Review of 15 patients with infected total knee replacements.
  • Surgical intervention involved prosthesis removal, rigorous debridement, and antibiotic irrigation.
  • Patients received prolonged systemic antibiotic therapy post-operatively.

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Main Results:

  • Complete eradication of infection was achieved in all 15 patients.
  • All patients were left with a functioning limb, enabling ambulation with assistive devices (caliper, splint, crutches, or sticks).
  • Three patients reported dissatisfaction due to residual pain.

Conclusions:

  • This limb salvage procedure is a viable and effective alternative to arthrodesis or amputation for managing persistent PJI after TKR.
  • The protocol is particularly beneficial when revision arthroplasty is not feasible, especially in cases involving constrained implants.