A two-stage approach to primary knee arthroplasty in the infected arthritic knee

Fourteen patients with either septic knee arthritis or osteomyelitis of the knee with marked joint destruction were treated by resection arthroplasty with the introduction of an antibiotic cement spacer block, appropriate antibiotic therapy, and subsequent primary total knee arthroplasty. Most patients with septic arthritis had chronic infection. Eight patients had positive cultures preoperatively; the remaining patients had either a culture negative purulent aspiration or diagnostic radiographic studies. All patients underwent reconstruction with primary total knee arthroplasty on an average of 3.1 months alter the initial stage procedure. Knee Society scores progressed from 46 preoperatively to 89 postoperatively, with an average range of motion from 3degrees to 105degrees. At latest clinical follow-up (average, 4.5 years), no patients had recurrence of infection. These data suggest that this method is successful in treating chronically infected knees with a 2-staged arthroplasty.