[Arthroscopic treatment of hematogenous infected total knee arthroplasty: 5 cases]

Abstract

Purpose of the study: The purpose of this retrospective study was to assess the contribution of arthroscopic treatment on hematogenous infected total knee arthroplasty.

Material and methods: Five patients were treated for hematogenous infected total knee arthroplasty. All patients had a posterior stabilized prosthesis that had been implanted without any element suggesting primary infection. Delay to infection after arthroplasty was 25 months on the average. Arthroscopic treatment included joint wash-out and synovectomy in combination with prolonged antibiotic therapy.

Results: One female patient, treated within 24 hours of the onset of infection, achieved cure without recurrence at 6 months follow-up. One other female patient died. Three patients required revision surgery after failure (two reimplantations in two procedures and one reimplantation in one procedure).

Discussion: The gravity of hematogenous infections of total knee arthroplasty is well known. Cure requires insertion of a new implant in three-quarters of the cases. Local arthroscopic treatment is not effective unless performed very early. Beyond this delay, it can at best limit local symptoms.