Late infection following total knee arthroplasty

ABSTRACT

During one year between August 1991 and July 1992, nine patients with nine infected total knee replacements were treated by a two-stage reimplantation with a six-weeks course of antibiotics. Average age at the time of index arthroplasty was 67 years. The primary diagnosis was rheumatoid arthritis in 4, osteoarthritis in 3 and post- traumatic arthritis in 2. The diagnosis of infection was established preoperatively by culture of a specimen obtained on aspiration in six knees, and by isotope bone scan in three. The period between the index arthroplasty and the onset of infection ranged from 5 to 36 months, average 11.6. The two-stage procedure included removal of all the components of the prosthesis and all cement, then six weeks of antibiotics and finally reimplantation with a total knee prosthesis. The follow up period ranged from 6-15 months, average 11 months. The final results were excellent in two cases, good in six and fair in one Limitation of flexion, weakness of quadriceps muscle and extension lag were the major problems encountered following reimplantation