Infection in Total Knee Arthroplasty
From diagnosis to treatment Special considerations
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Infection represents the second most common cause of TKA failure, with a primary rate between 1% and 3%. Diagnosis of TKA infection can be complex. Imaging, laboratory, isotope scanning, aspiration, histology and sonication of the removed implant should guide to a proper diagnosis. The best management is still debating, especially in the presence of drug-resistant bacteria, and many treatment options are nowadays available: chronic suppressive antibiotics, debridement with insert exchange, single- or two-stage reimplantation. Additionally, resection arthroplasty, arthrodesis and amputation may...
Infection represents the second most common cause of TKA failure, with a primary rate between 1% and 3%. Diagnosis of TKA infection can be complex. Imaging, laboratory, isotope scanning, aspiration, histology and sonication of the removed implant should guide to a proper diagnosis. The best management is still debating, especially in the presence of drug-resistant bacteria, and many treatment options are nowadays available: chronic suppressive antibiotics, debridement with insert exchange, single- or two-stage reimplantation. Additionally, resection arthroplasty, arthrodesis and amputation may represent salvage procedures in the setting of recurrent infection and complex soft tissue defects. At revision TKA, surgeon should have a versatile modular revision system with traditional metal augments or structural allografts, tantalum cones or porous sleeves, modular stems, and special revision knee prostheses. This book should be especially useful to all knee surgeons who routinely perform primary and revision knee arthroplasty as they will inevitably face one of the most devastating and costly complications in TKA.
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