Revision of septic total knee arthroplasty

Nine patients with septic total knee arthroplasties (TKA) were treated between 1980 and 1984; six were gram-positive infections and three were gram-negative. Initial treatment included the maintenance of all solidly fixed components. Patients with loose components were treated with removal of all prosthetic material and subsequent reimplantation after a six-week course of antibiotics. At follow-up examination six of nine patients had satisfactory results. One patient maintained his original femoral and tibial components and one patient required a knee fusion to treat his recurrent gram-negative infection. Overall, complications were associated with chronic infection, gram-negative infection, and abnormalities of the extensor mechanism.