Related Experiment Video
Updated: Mar 14, 2026
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
[Infection of a total knee replacement following repeated joint aspiration - a case report]
Unlabelled:
An 80-year old male presented with an infected knee replacement following repeated joint aspirations. They were carried out due to recurrent hemarthrosis resulting from an initially missed quadriceps tendon injury. The infection was eradicated first after arthrodesis. This case highlights that prosthetic joints are sensitive to infection, which once established can be difficult to eradicate. Careful consideration is necessary before aspirating prosthetic joints. Diagnosing quadriceps tendon injuries can be difficult and they must be included in the differential diagnosis of traumatic hemarthrosis. We review the initials steps in the diagnosis and management of periprosthetic joint infections.
Key Words:
periprosthetic joint infection, total knee replacement, quadriceps tendon rupture, hemarthrosis, joint aspiration. Correspondence: Eythor Orn Jonsson, eythororn@gmail.com.
Insights
Infected knee replacements are difficult to treat, especially after repeated joint aspirations for hemarthrosis. Early diagnosis of quadriceps tendon injuries is crucial to prevent complications like periprosthetic joint infection.
Area of Science:
- Orthopedic Surgery
- Infectious Disease
Background:
- Periprosthetic joint infection (PJI) is a serious complication after total knee replacement.
- Recurrent hemarthrosis can necessitate joint aspirations, increasing infection risk.
- Quadriceps tendon rupture is a potential cause of hemarthrosis that can be initially missed.
Observation:
- An 80-year-old male developed an infected knee replacement following multiple joint aspirations for hemarthrosis.
- The hemarthrosis was attributed to an undiagnosed quadriceps tendon injury.
- Infection eradication required arthrodesis after initial treatment failure.
Findings:
- Prosthetic joints are highly susceptible to infection.
- Established periprosthetic joint infections are challenging to eradicate.
- Arthrodesis was necessary to resolve the infection in this case.
Implications:
- Careful consideration and risk-benefit analysis are needed before aspirating prosthetic joints.
- Quadriceps tendon injuries should be considered in the differential diagnosis of traumatic hemarthrosis.
- Timely diagnosis and management of PJI are critical for favorable outcomes.
