The infected total knee replacement: the worst and unfortunately most frequent complication

Abstract

Periprosthetic joint infection (PJI) is the most common reason for early revision following total knee replacement surgery. It is associated with poor patient outcomes, prolonged inpatient stay, costly surgical interventions and extended treatment in the community. Despite advances in surgical technique, implants and operating room technology, PJI is an unresolved problem in arthroplasty. As the volume of knee replacement procedures continues to increase, PJI continues to be a significant burden for the health service. Treatment of PJI has historically been with two-stage exchange, but with single-stage revision surgery increasing in popularity for selected cases. In this review we aim to follow the patient journey from presentation to diagnosis and treatment, and discuss contemporary management strategies when treating this devastating complication.