Deep Infection after Total Knee Arthroplasty

ABSTRACT

PURPOSE: To analyze the clinical results of treatment for infected total knee arthroplasty(TKA). MATERIALS AND METHODS: Between October 1993 and March 2003, 20 patients with infection after TKA were treated at our department. The average follow-up period was 3 years 8 months and the average age was 65.5 years(range, 50-79); there were 18 females and two men. Infected TKAs were managed with several methods ; 16 patients were treated two-stage reimplantation, 2 arthrodesis, and 2 debridement and polyethylene insert change. We assessed knee function before and after revision, according to the knee rating system of the Hospital for Special Surgery. RESULTS: Prior to revision operation, the average knee score in 16 reimplantation cases was 49.3 points and the average range of motion was 64.9 degrees. After revision, the average knee score was 80.5 points and the average range of motion was 90.3 degrees. Two of them relapsed within postoperative two weeks, and then we performed debridement. There was one recurrence of infection after debridement and polyethylene insert change and then we performed two stage reimplantation. Two patients had complete union at each 4, 5 months after arhtrodesis. CONCLUSION: Thoughtful method of treatment should be decided and precise operative technique should be performed in managing infected TKA.