Related Experiment Video
Updated: May 10, 2026

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
[Infected knee prostheses. Part 1: early infection or acute hematogenous infection]
P Herrmann1, P Thoele, V Heppert
1Abteilung Unfall-, Wirbelsäulen- und Gelenkchirurgie, Asklepios-Südpfalzklinik Kandel, Luitpoldstr. 14, 76870 Kandel, Germany. pe.herrmann@asklepios.com
Objective:
Treatment of an early total knee arthroplasty (TKA) infection with the goal of salvaging the implant.
Indications:
Early postoperative infections within the first 4 weeks. The acute hemtogenous infection of the knee joint with TKA and duration of symptoms for a maximum of 4 weeks.
Contraindications:
Unsuitable for anesthesia, high acute infection with sepsis and risk for bacteremia with danger to life, large soft tissue damage where plastic surgery coverage is not possible.
Surgical Technique:
Arthrotomy, synovectomy, inlay removal, jet lavage, instillation of polyhexanide, new inlay, drainage and infusion-aspiration-drainage if necessary, wound closure with plastic surgery if necessary.
Postoperative Management:
Infusion-aspiration-drainage with polyhexanide for 3 days or drainage for 3 days. Continuous passive motion (CPM) with increasing range of motion (ROM) 0-0-30°. Removal of the drain after 5 days and mobilization with increasing ROM and full weight-bearing.
Results:
The success rate for the salvage procedure is about 70%.
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