Diagnosis and management of the infected total knee replacement: a practical surgical guide
Abstract Purpose Prosthetic joint infection (PJI) after total knee arthroplasty (TKA) is a significant burden in health care. Diagnosis and proper management are challenging. A standardised procedure for the diagnostic workup and surgical management provides clear benefits in outcome. Methods Severa...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40634-021-00333-2 |
| _version_ | 1797321275750744064 |
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| author | Akos Zahar Martin Sarungi |
| author_facet | Akos Zahar Martin Sarungi |
| author_sort | Akos Zahar |
| collection | DOAJ |
| description | Abstract Purpose Prosthetic joint infection (PJI) after total knee arthroplasty (TKA) is a significant burden in health care. Diagnosis and proper management are challenging. A standardised procedure for the diagnostic workup and surgical management provides clear benefits in outcome. Methods Several diagnostic protocols and definitions for PJI were established in recent years. Proper PJI diagnosis remains critical for success and for choosing the optimal treatment option. A distinct workup of diagnostic steps, the evaluation of the results in a multidisciplinary setup and the meticulous surgical management of the infection are the key factors of successful treatment. Results The management of PJI after TKA consists of early revision with debridement and implant retention (DAIR) in early cases or staged revision in late infections beyond 30 days postoperative or after onset of acute symptoms. The revision is performed as a two‐stage procedure with the use of a fixed or mobile antibiotic spacer, or in selected cases as a single‐stage operation with the use of local and systemic antibiotic treatment. Conclusions This paper reflects the opinion of two revision surgeons who follow the same protocol for diagnosis and treatment of PJI after TKA, highlighting the key steps in diagnosis and management. Level of evidence Expert’s opinion |
| first_indexed | 2024-03-08T04:55:14Z |
| format | Article |
| id | doaj.art-1ae6cbaca0a942b89ad3fda55f02e3dc |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-03-08T04:55:14Z |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-1ae6cbaca0a942b89ad3fda55f02e3dc2024-02-07T15:16:41ZengWileyJournal of Experimental Orthopaedics2197-11532021-01-0181n/an/a10.1186/s40634-021-00333-2Diagnosis and management of the infected total knee replacement: a practical surgical guideAkos Zahar0Martin Sarungi1Department of Orthopaedic & Trauma SurgeryHelios Klinikum Emil von BehringWalterhöferstrasse 1114165BerlinGermanyOrthopaedic DepartmentThe Golden Jubilee National HospitalGlasgowScotland, UKAbstract Purpose Prosthetic joint infection (PJI) after total knee arthroplasty (TKA) is a significant burden in health care. Diagnosis and proper management are challenging. A standardised procedure for the diagnostic workup and surgical management provides clear benefits in outcome. Methods Several diagnostic protocols and definitions for PJI were established in recent years. Proper PJI diagnosis remains critical for success and for choosing the optimal treatment option. A distinct workup of diagnostic steps, the evaluation of the results in a multidisciplinary setup and the meticulous surgical management of the infection are the key factors of successful treatment. Results The management of PJI after TKA consists of early revision with debridement and implant retention (DAIR) in early cases or staged revision in late infections beyond 30 days postoperative or after onset of acute symptoms. The revision is performed as a two‐stage procedure with the use of a fixed or mobile antibiotic spacer, or in selected cases as a single‐stage operation with the use of local and systemic antibiotic treatment. Conclusions This paper reflects the opinion of two revision surgeons who follow the same protocol for diagnosis and treatment of PJI after TKA, highlighting the key steps in diagnosis and management. Level of evidence Expert’s opinionhttps://doi.org/10.1186/s40634-021-00333-2Prosthetic joint infection (PJI)Total knee arthroplasty (TKA)Diagnostic protocolSurgical treatmentOne‐stage septic exchangeTwo‐stage revision |
| spellingShingle | Akos Zahar Martin Sarungi Diagnosis and management of the infected total knee replacement: a practical surgical guide Journal of Experimental Orthopaedics Prosthetic joint infection (PJI) Total knee arthroplasty (TKA) Diagnostic protocol Surgical treatment One‐stage septic exchange Two‐stage revision |
| title | Diagnosis and management of the infected total knee replacement: a practical surgical guide |
| title_full | Diagnosis and management of the infected total knee replacement: a practical surgical guide |
| title_fullStr | Diagnosis and management of the infected total knee replacement: a practical surgical guide |
| title_full_unstemmed | Diagnosis and management of the infected total knee replacement: a practical surgical guide |
| title_short | Diagnosis and management of the infected total knee replacement: a practical surgical guide |
| title_sort | diagnosis and management of the infected total knee replacement a practical surgical guide |
| topic | Prosthetic joint infection (PJI) Total knee arthroplasty (TKA) Diagnostic protocol Surgical treatment One‐stage septic exchange Two‐stage revision |
| url | https://doi.org/10.1186/s40634-021-00333-2 |
| work_keys_str_mv | AT akoszahar diagnosisandmanagementoftheinfectedtotalkneereplacementapracticalsurgicalguide AT martinsarungi diagnosisandmanagementoftheinfectedtotalkneereplacementapracticalsurgicalguide |