Arthroscopic irrigation and debridement of infected total knee arthroplasty: Report of two cases

Flood, John N.; Kolarik, Dennis B.

doi:10.1016/s0749-8063(88)80024-0

Cited by 35 publications

(18 citation statements)

References 23 publications

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“…Many of these papers have substantial shortcomings. They mix up hip and knee arthroplasties [10,12], reveal short minimal follow-up times of only several months [4,11,13,16,17], report less than ten cases [8,13,[18][19][20] or report only specific pathogens [7,9] such as methicillinresistant Staphylococcus aureus (MRSA) [1,3].…”

Section: Introductionmentioning

confidence: 99%

Pathogen-driven decision for implant retention in the management of infected total knee prostheses

Zürcher-Pfund

Uçkay

Legout

et al. 2013

International Orthopaedics (SICOT)

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Purpose In prosthetic joint infections (PJIs) of the knee, debridement with implant retention is associated with a high risk of recurrence. Methods A single-centre cohort study was performed with extensive analysis of the literature covering 1980-2012. Results In 21 patients (mean age 80.4 years, 19 immunosuppressed), in association with 1.5-three months of antibiotic treatment, an attempt was made to salvage the prosthesis by open (11 patients) or arthroscopic (ten patients) debridement. After a mean follow-up of seven years (range four-20 years), patients were in remission in seven cases (33 %). Remission was achieved in 0 % of all methicillin-resistant Staphylococcus aureus (MRSA) infections (zero/three), in 0 % (zero/three) of methicillin-resistant coagulase-negative staphylococcal infections, in 29 % (two/seven) of methicillin-sensitive S. aureus infections and in 75 % (three/four) of infections due to streptococci. The literature review focused on implant preserving approaches yielded 599 cases with an overall success rate of 47 % (284/599) and significantly more remissions in streptococcal vs staphylococcal knee PJIs (43/54 vs 144/324; p< 0.01, odds ratio 4.9, 95 % confidence interval 2.4-10.9).Conclusions In addition to established indications for explantation such as implant loosening, sinus tract or methicillin resistance, the decision for debridement and retention of knee PJIs should also depend on the pathogen. Implant preservation is futile with methicillin-resistant staphylococci, but seems to be a valid option for streptococcal PJIs.

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Section: Introductionmentioning

confidence: 99%

Pathogen-driven decision for implant retention in the management of infected total knee prostheses

Zürcher-Pfund

Uçkay

Legout

et al. 2013

International Orthopaedics (SICOT)

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“…However, there are few reports of arthroscopic debridement. We found only one other series 2 and two case reports 3,4 in the literature on its use for the infected TKR.…”

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confidence: 95%

Arthroscopic debridement in the treatment of the infected total knee replacement

Dixon

Parish

Cross

2004

The Journal of Bone and Joint Surgery. British volume

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39nfection is a potentially disastrous complication of total knee replacement (TKR). Retention of the prosthesis has been associated with high rates of persistent infection. Our study shows that in selected situations, arthroscopic debridement may allow retention of the prosthesis and eradication of the infection. However, the prosthesis must be stable, the surgical technique must be meticulous and specific antibiotics must be taken for a lengthy period. Arthroscopic debridement should be considered as an alternative to an open technique, or revision, for the infected TKR.

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“…However, debridement or synovectomy through an open or arthroscopic procedure is recommended in selected patients if neither signs of ostitis nor evidence of a loose prosthetic component is confirmed on radiographic evaluation [1–4, 7–9]. Success rates of arthroscopic irrigation and debridement for infected TKA have been lower than those of the open procedure [4].…”

Section: Discussionmentioning

confidence: 99%

“…Arthroscopic debridement and irrigation is one of the treatment options available for pyogenic arthritis after TKA in selected patients who do not present with radiographic evidence of loosening of components [1–4]. However, arthroscopic debridement and synovectomy of the posterior compartment of the knee with prosthesis are difficult.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic Debridement of the Posterior Compartment of the Knee after Total Knee Arthroplasty

Ohishi

Fujita

Suzuki

et al. 2014

Case Reports in Orthopedics

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Arthroscopic debridement of the posterior compartment of the knee after total knee arthroplasty is difficult because it is tough to obtain intercondylar notch views. Herein, we performed arthroscopic debridement of the posterior compartment of an infected knee after total knee arthroplasty by using a transseptal portal in a 62-year-old woman with rheumatoid arthritis. Palpation of anatomical landmarks and posterior capsule protection are important for safe creation of a transseptal portal following to making 2 posterior portals.

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Arthroscopic irrigation and debridement of infected total knee arthroplasty: Report of two cases

Cited by 35 publications

References 23 publications

Pathogen-driven decision for implant retention in the management of infected total knee prostheses

Pathogen-driven decision for implant retention in the management of infected total knee prostheses

Arthroscopic debridement in the treatment of the infected total knee replacement

Arthroscopic Debridement of the Posterior Compartment of the Knee after Total Knee Arthroplasty

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