Total knee arthroplasty after prior bone or joint sepsis about the knee

The current study was done to determine the effect of current methods to diagnose and treat infection on the incidence of deep prosthetic infection after total knee arthroplasty for patients with previous sepsis or osteomyelitis about the knee. Between 1989 and 1999, one surgeon did 20 consecutive primary total knee arthroplasties in 19 patients with a previous history of either septic arthritis or osteomyelitis about the knee. Antibiotic-impregnated cement was used in all patients. One patient was lost to followup and two patients died before 2 years from the arthroplasty. The remaining 16 patients were followed up for an average of 5 years (range, 2-11 years). There was one (5%) recurrent deep periprosthetic infection for which the patient required resection arthroplasty at 3.5 years. No patients required chronic antibiotic suppression. With careful preoperative and intraoperative evaluation and the routine use of antibiotic bone cement for fixation, total knee arthroplasty, in patients with prior bone or joint sepsis about the knee can provide good pain relief, functional improvement, and an acceptably low rate of deep prosthetic infection.