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The Journal of Bone and Joint Surgery (American) 85:S75-S80 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Diagnosis and Management of Infection After Total Knee Arthroplasty

Dean T. Tsukayama, MD, Victor M. Goldberg, MD and Richard Kyle, MD

Corresponding author: Dean T. Tsukayama, MD
Department of Medicine, Division of Infectious Diseases, Hennepin County Medical Center, 701 Park Avenue South, Minneapolis, MN 55415. E-mail address: tsuka001@umn.edu

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

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   Introduction
 
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 infection 1. 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 pain 2.


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  		TABLE I: Risk Factors for Infection Following Total Knee Arthroplasty

 
Aspiration of the affected knee should be among the first diagnostic tests . . . [Full Text of this Article]


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