Total Knee Arthroplasty Following a Sepsis History
The importance of a complete history and physical examination is stressed at the time of medical school. And if that history includes a previous history of joint sepsis, the performance of a “routine” TKA is now more complicated. The obvious question remains, has the infection been eradicated? While on the surface, it may appear easy to rule out an active infection, but certainly the other issue is a bit more difficult. Is there residual or dormant infection that could become clinically significant once soft tissue releases and bone cuts are performed?
KeywordsKnee sepsis Preoperative radiographs Medial parapatellar approach Patellar preparation Two-stage revision arthroplasty Postoperative radiographs
- 2.Jerry GJ Jr, Rand JA, Ilstrup D. Old sepsis prior to total knee arthroplasty. Clin Orthop Relat Res. 1988;(236):135–40.Google Scholar
- 4.Lee GC, Pagnano MW, Hanssen AD. Total knee arthroplasty after prior bone or joint sepsis about the knee. Clin Orthop Relat Res. 2002;(404):226–31.Google Scholar
- 7.Bohl DD, Shen MR, Kayupov E, Cvetanovich GL, Della Valle CJ. Is hypoalbuminemia associated with septic failure and acute infection after revision total joint arthroplasty? A study of 4517 patients from the National Surgical Quality Improvement Program. J Arthroplasty. 2016;31(5):963–7.CrossRefPubMedGoogle Scholar
- 8.Fu MC, D’Ambrosia C, McLawhorn AS, Schairer WW, Padgett DE, Cross MB. Malnutrition increases with obesity and is a stronger independent risk factor for postoperative complications: a propensity-adjusted analysis of total hip arthroplasty patients. J Arthroplasty. 2016;31(11):2415–21.CrossRefPubMedGoogle Scholar
- 27.Parvizi J, Ghanem E, Menashe S, et al. Periprosthetic infection: what are the diagnostic challenges? J Bone Joint Surg Am. 2006;88-A(Suppl 4):138–47.Google Scholar