Arthroscopic Treatment of Acutely Infected Total Knee Arthroplasty

Chul-Won Ha; Kun-Sik Yu

doi:10.4055/jkoa.2007.42.2.184

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Ha and Yu: Arthroscopic Treatment of Acutely Infected Total Knee Arthroplasty

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(2): 184-189.

Published online: 30 April 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.2.184

Arthroscopic Treatment of Acutely Infected Total Knee Arthroplasty

Chul-Won Ha, M.D., Kun-Sik Yu, M.D.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Address reprint requests to Chul-Won Ha, M.D. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea. Tel: +82.2-3410-0275, Fax: +82.2-3410-0084, hacw@smc.samsung.co.kr

Abstract

Purpose

This study is to evaluate the results of arthroscopic treatment for an acutely infected total knee arthroplasty (TKA) and to determine the protocol for a successful arthroscopic treatment.

Materials and Methods

Of 16 cases of acutely infected TKA treated at this institution, 7 cases treated with arthroscopic debridement were retrospectively reviewed. The indication for arthroscopic debridement was patients with a radiographically stable prosthesis and within 72 hours of the onset of symptoms. The necessity and method of the secondary procedures were determined using a follow up of the C-reactve protein (CRP) test and physical examination after the primary arthroscopic debridment. Successful treatment was defined as no recurrence or no re-operation by the final follow-up.

Results

All 7 cases were treated with a retention of the prosthesis. 3 cases were treated successfully with primary arthroscopic debridement only. Three cases were treated with open debridement after primary arthroscopic debridement. One case was treated with repeated arthroscopic debridement after primary arthroscopic debridement.

Conclusion

Arthroscopic debridement is an effective treatment option for an acutely infected TKA within 72 hours of the onset of symptoms. A careful CRP follow up is suggested as the critical index to determine the secondary procedure for successful treatment of an acutely infected TKA by arthroscopic debridement.

Keywords: Knee, Total knee arthroplasty, Acutely deep infection, Arthroscopic debridement

Figures and Tables

Table 1

Analysis and Outcome of Arthroscopic Debridement of an Acutely Infected Total Knee Arthroplasty

^*Simultaneous bilateral infection.

Table 2

Clinical Data of Patients with an Acutely Infected Total Knee Arthroplasty Treated with a Primary Arthroscopic Debridement

TKA, total knee arthroplasty; MSSA, methicillin sensitive Staphylococcus aureus; MRSA, methicillin resistive Staphylococcus aureus.

Table 3

Clinical Data of Patients with an Acutely Infected Total Knee Arthroplasties Treated with a Secondary Procedure after the Primary Arthroscopic Debridement

TKA, total knee arthroplasty; MSSA, methicillin sensitive Staphylococcus aureus; DM, diabetes mellitus; KT, kidney transplantation; CRF, chronic renal failure.

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