Infected knee prostheses: Part 1: Early infection or acute hematogenous infection

Objective: Treatment of an early total knee arthroplasty (TKA) infection with the goal of salvaging the implant. Indications: Early postoperative infections within the first 4 weeks. The acute hemtogenous infection of the knee joint with TKA and duration of symptoms for a maximum of 4 weeks. Contraindications: Unsuitable for anesthesia, high acute infection with sepsis and risk for bacteremia with danger to life, large soft tissue damage where plastic surgery coverage is not possible. Surgical technique: Arthrotomy, synovectomy, inlay removal, jet lavage, instillation of polyhexanide, new inlay, drainage and infusion-aspiration-drainage if necessary, wound closure with plastic surgery if necessary. Postoperative management: Infusion-aspiration- drainage with polyhexanide for 3 days or drainage for 3 days. Continuous passive motion (CPM) with increasing range of motion (ROM) 0-0-30. Removal of the drain after 5 days and mobilization with increasing ROM and full weight-bearing. Results: The success rate for the salvage procedure is about 70 %. © 2013 Springer-Verlag Berlin Heidelberg.