The Infected Total Knee: Management Options

The management of infection after total knee arthroplasty depends on the chronicity of the infection, host factors, and sensitivity of the infecting bacteria. Two-stage salvage consisting of removal of implants and cement, placement of an antibiotic spacer, and appropriate intravenous antibiotic therapy followed by reimplantation with an antibiotic-impregnated cement appears to be the predominant approach to managing this complication. The use of articulated spacers consisting of the sterilized femoral and polyethylene components with antibiotic cement allows maintenance of motion and bone stock. This report details the author’s experience with 44 infected knee arthroplasties.