Management of Complex Peri-Prosthetic Joint Infection Following Total Knee Arthroplasty with Soft Tissue Defects:...

Area of Science:

• Orthopaedic Surgery
• Plastic and Reconstructive Surgery
• Infectious Diseases

Background:

• Periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) with soft tissue compromise poses significant reconstructive challenges.
• Effective management necessitates infection eradication and restoration of soft tissue coverage and limb function.

Purpose of the Study:

• To report outcomes of a patient-specific, multidisciplinary orthoplastic approach for complex knee PJI.
• To demonstrate the feasibility and importance of customized strategies in tertiary referral centers.

Main Methods:

• Retrospective review of five patients with complex knee PJI and soft tissue compromise.
• Management involved a single orthopaedic and two plastic surgeons using custom spacers, patient-specific orthopaedic reconstruction, and individualized soft tissue techniques.

Main Results:

• All five patients achieved durable soft tissue coverage and infection eradication.
• Reconstructive techniques included primary closure, local flaps, gastrocnemius flaps, and custom spacers for bone defects.

Conclusions:

• An individualized, multidisciplinary orthoplastic strategy is effective for complex knee PJI with soft tissue defects.
• Customization is crucial for infection control and limb preservation in these challenging cases.