title: Low-grade periprosthetic knee infection: diagnosis and management.
abstract: Diagnosis and management of low-grade periprosthetic knee infection are still controversial and debatable. The diagnosis of low-grade infection after total knee arthroplasty is often complex, as clinical symptomatology and diagnostic studies are highly conflicting and knees often exhibit well-fixed components. Although the criterion standard for staged reimplantation is interim placement of an antibiotic-loaded spacer, less-invasive surgical procedures have been advocated for managing infections caused by low-virulence bacteria. Debridement with polyethylene exchange and single-stage reimplantation could offer advantages, such as fewer surgeries, reduced potential for intraoperative complications, and lower direct social costs. The aim of this narrative review was to analyze the literature to evaluate the effectiveness of different surgical procedures in managing low-grade periprosthetic knee infections. Additionally, the most reliable investigations for diagnosing total knee infection caused by low-virulence bacteria were reviewed.
  
  
  METHODS
  Level V.
authors.affiliation: Department of Medicine and Science for Health, University of Molise, Via Francesco De Sanctis, Campobasso, Italy, vassomichele@gmail.com.
authors.forename: Michele
authors.initials: M
authors.lastname: Vasso
authors.forename: Alfredo
authors.initials: A
authors.lastname: Schiavone Panni
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003646:Debridement / Q000379:methods*; D003952:Diagnostic Imaging / Q000379:methods*; D006801:Humans; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000628:therapy*; D012086:Reoperation
chemical_list: D000900:Anti-Bacterial Agents