Abstract
Since 1990, a total of ten joints in nine patients with infected total knee arthroplasty have been treated in our department within 21 days of the onset of infection. Their radiographs showed no evidence of implant loosening or “moth-eaten” appearance. They underwent synovectomy, debridement, and continuous irrigation without implant removal. Continuous irrigation was maintained for 7–29 days. It was possible to retain implants in eight joints of seven patients. Two joints of two patients were removed. Pain disappeared in all eight joints in which the implants were retained. Four patients could walk with one cane; one patient could walk with one crutch. Range of motion in five joints remained over 100°. We recommend synovectomy, debridement, and continuous irrigation to cure an early stage infection of total knee arthroplasty.
Résumé
Depuis 1990, dix articulations chez neuf malades avec une arthroplastie totale infectée du genou ont été traité dans notre département dans les 21 jours après le début de l’infection. Les radiographies n’ont pas montré de descellement d’implants ou d’anomalie de la texture osseuse. Ils ont subi synovectomie, débridement et irrigation continue sans ablation de l’implant. L’irrigation continue a été maintenue pour sept à 29 jours. Il a été possible de conserver les implants de huit articulations chez sept malades. Deux articulations de deux malades ont subi l’ablation de l’implant. La douleur a disparu de toutes les articulations ou les implants avaient été conservés. Quatre malades devaient marcher avec une canne et un avec une béquille. L’amplitude de mobilité est restée au-dessus de 100° pour cinq articulations. Nous recommandons la synovectomie, le débridement et l’irrigation continue pour traiter une infection précoce d’arthroplastie totale du genou.
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