[Arthroscopic treatment of hematogenous infected total knee arthroplasty: 5 cases].
OBJECTIVE
The purpose of this retrospective study was to assess the contribution of arthroscopic treatment on hematogenous infected total knee arthroplasty.


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).


CONCLUSIONS
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.
Vidil
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Service de Chirurgie Orthopédique et Traumatologique, Hôpital André-Mignot, 177, rue de Versailles, 78157 Le Chesnay Cedex.
Beaufils
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D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001182:Arthroscopy / Q000379:methods*; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D011008:Pneumococcal Infections / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D000074402:Synovectomy; D007507:Therapeutic Irrigation / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents