Outcome of infected total knee arthroplasty

The results of 44 cases of deep infection after total knee arthroplasty were reviewed. The average age of the patients was 62 years (range, 31-81 years), and all had positive bacterial cultures from deep aspiration or tissue biopsy. Osteitis was revealed in 22 cases. One case was initially treated with antibiotics only, 27 cases were treated with surgical debridement and antibiotics, and 16 cases had immediate removal of the prosthesis. In 21 cases, failed debridement was followed by removal of the prosthesis. Revision arthroplasty was attempted in 15 of the 37 cases in which the prosthesis was removed; the infection was cured in 11 cases. A total of 25 cases that underwent removal of the prosthesis had an arthrodesis performed, and 4 ultimately underwent amputation. In no case of osteitis was the infection cured merely by debridement and antibiotics, and the index prostheses were retained mainly in cases in which osteitis did not develop.