Diagnosis and Management of Infection Following Total Knee Arthroplasty

  • Barry D. Brause


Prosthetic total knee arthroplasty has become commonplace, restoring full function to severely disabled individuals. However, infection of these prostheses, which occurs in 1–2% of patients, is a catastrophic event associated with protracted hospitalization, major financial expenditure, and renewed disability. The indwelling metallic prosthesis and the polymethylmethacrylate cement, which binds the metal alloy to adjacent bone, represent foreign bodies and predispose both joint space and bone to septic processes. Metallic foreign bodies contribute to local sepsis experimentally by decreasing the quantity of bacteria necessary to establish infection and by permitting pathogens to persist on the surface of the avascular material, sequestered from circulating immune factors (leukocytes, antibody, and complement) and systemic antibiotics [7]. The polymethylmethacrylate cement represents additional foreign material which has been shown to inhibit phagocytic and lymphocytic function in vitro [10,15–17].


Total Knee Arthroplasty Bone Cement Total Knee Replacement Prosthetic Joint Infection Total Joint Replacement 
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© Springer-Verlag New York, Inc 1985

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  • Barry D. Brause

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