[Infected knee prostheses. Part 1: early infection or acute hematogenous infection]. / Die infizierte knieprothese. Teil 1: frühinfekt oder akuter hämatogener Infekt.

ABSTRACT

OBJECTIVE: Treatment of an early total knee arthroplasty (TKA) infection with the goal of salvaging the implant. INDICATIONS Early postoperative infections within the first 4 weeks. The acute hemtogenous infection of the knee joint with TKA and duration of symptoms for a maximum of 4 weeks. CONTRAINDICATIONS Unsuitable for anesthesia, high acute infection with sepsis and risk for bacteremia with danger to life, large soft tissue damage where plastic surgery coverage is not possible. SURGICAL TECHNIQUE Arthrotomy, synovectomy, inlay removal, jet lavage, instillation of polyhexanide, new inlay, drainage and infusion-aspiration-drainage if necessary, wound closure with plastic surgery if necessary. POSTOPERATIVE MANAGEMENT Infusion-aspiration-drainage with polyhexanide for 3 days or drainage for 3 days. Continuous passive motion (CPM) with increasing range of motion (ROM) 0-0-30°. Removal of the drain after 5 days and mobilization with increasing ROM and full weight-bearing. RESULTS: The success rate for the salvage procedure is about 70%.