[Periprosthetic knee infection. One-stage exchange]

Abstract

Systematic diagnostics and successful therapy of periprosthetic infection of the knee can only be achieved under optimal conditions. History, clinical examination and an elevated CRP level are the basis for suspicion of infection. Diagnosis is confirmed by identification of the pathogen through aspiration of the joint under sterile conditions. The microbiological examination is done in a laboratory, which is specialised in foreign body infections. Identification of the causing pathogens and their resistance pattern are essential to determine the topical and systemic course of antibiotics. When these conditions are fulfilled, the one-stage exchange procedure offers great advantages in comparison with procedures performed in two or more stages for all those involved--patients, surgeons and health care systems--while providing the same chance of a successful elimination of the infection, with an even better functional outcome. Currently, the treatment costs are not adequately reimbursed. In the future, prompt treatment of these especially unfortunate patients will only be possible, if the tremendous resources consumed by these patients are fully covered.