Diagnosis and Management of Infection After Total Knee Arthroplasty

The key to successful management of an infection at the site of a total knee arthroplasty is an early and accurate diagnosis that allows prompt treatment. Therefore, it is critical that every patient with pain at the site of a total knee arthroplasty is assessed for the presence of infection1. The usual presentation is characterized by constant pain, warmth, and effusion. Erythema is unusual. It is important to elicit the history of the perioperative course that followed the primary total knee replacement: Did the original wound heal without delay? Was there any postoperative drainage? A complete history ( Table I), physical examination, plain radiographs, and other diagnostic studies discussed below are critical to confirm the diagnosis of infection and to rule out other causes of knee pain2.