Infection after total knee replacement: diagnosis and treatment

Area of Science:

• Orthopedic surgery
• Infectious diseases
• Biomedical engineering

Background:

• Infection after total knee replacement (IATJ) is a rare complication with significant morbidity, mortality, and cost implications.
• Gram-positive cocci, including Staphylococcus coagulase-negative and Staphylococcus aureus, are the most common pathogens (>50%).
• Patient-related, surgical, and post-operative factors contribute to IATJ risk.

Purpose of the Study:

• To summarize the current understanding of infection after total knee replacement.
• To highlight diagnostic methods and risk factors.
• To outline treatment strategies for IATJ.

Main Methods:

• Review of clinical symptoms and complementary diagnostic methods for IATJ.
• Analysis of risk factors associated with IATJ.
• Evaluation of treatment options including antibiotic therapy and surgical interventions.

Main Results:

• IATJ is associated with increased morbidity, mortality, and healthcare costs.
• Common pathogens include Gram-positive cocci like Staphylococcus species.
• Risk factors span patient, surgical, and post-operative domains.

Conclusions:

• Accurate diagnosis of IATJ relies on clinical symptoms and complementary methods.
• Treatment is individualized, typically combining systemic antibiotics and surgery.
• Prosthesis exchange (one or two stages) is the primary surgical approach; debridement with retention is an option for select acute cases.