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Treatment options for infected knee arthroplasties
F M Ivey1, C A Hicks, J H Calhoun
1Department of Surgery, University of Texas, Medical Branch, Galveston 77550-2772.
Reviews of Infectious Diseases
|May 1, 1990
Summary
Total knee arthroplasty infections are often polymicrobic, with Staphylococcus species being common. Resection arthroplasty effectively controls infection but may require further surgery for optimal function.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
Background:
- Total knee arthroplasty (TKA) infections pose significant challenges in orthopedic surgery.
- Bacterial pathogens, particularly Staphylococcus species, are frequently implicated in TKA infections.
Purpose of the Study:
- To evaluate the efficacy of different surgical strategies for managing TKA infections.
- To compare outcomes of resection arthroplasty, debridement, and reimplantation for infected TKAs.
Main Methods:
- Retrospective review of 24 TKA infections in 23 patients over 9 years.
- Analysis of treatment approaches including resection arthroplasty, debridement, and reimplantation.
- Assessment of infection control and patient ambulation status at follow-up.
Main Results:
- Resection arthroplasty achieved infection control in all 13 treated patients, with 11 ambulatory.
- Debridement controlled infection in 3 of 10 knees, with 6 of 9 patients ambulatory.
- Reimplantation following resection arthroplasty resulted in ambulatory patients without infection.
Conclusions:
- Resection arthroplasty is a reliable method for controlling TKA infections but can result in joint instability.
- Reimplantation offers the best potential for achieving pain-free ambulation in selected TKA infection cases.
- Optimal management of TKA infections requires careful consideration of surgical approach and patient selection.