Abstract
Arthroscopic debridement of infected knee arthroplasty is rarely used. Currently, it has a limited role as complete biofilm clearance is theoretically impossible. It is most effective in the very early phase of acute presentations of infected knee arthroplasty. It can be of use in cases where the organism is not associated with strong biofilm, in patients of extreme frailty, as an adjunct to suppressive antimicrobial medical therapy or as part of a diagnostic workup. If performed, high volumes of fluid and accessory portals should be used.
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References
Rand JA. Alternatives to reimplantation for salvage of the total knee arthroplasty complicated by infection. J Bone Joint Surg Am. 1993;75:282–9.
Rand JA, Bryan RS. Reimplantation for the salvage of an infected total knee arthroplasty. J Bone Joint Surg Am. 1983;65:1081–6.
Peersman G, Laskin R, Davis J, Peterson M. Infection in total knee replacement: a retrospective review of 6489 total knee replacements. Clin Orthop Relat Res. 2001;392:15–23.
Berbari EF, Hanssen AD, Duffy MC, Steckelberg JM, Ilstrup DM, Harmsen WS, et al. Risk factors for prosthetic joint infection: case-control study. Clin Infect Dis. 1998;27:1247–54.
Choi HR, von Knoch F, Zurakowski D, Nelson SB, Malchau H. Can implant retention be recommended for treatment of infected TKA? Clin Orthop Relat Res. 2011;469:961–9.
Byren I, Bejon P, Atkins BL, Angus B, Masters S, McLardy-Smith P, et al. One hundred and twelve infected arthroplasties treated with 'DAIR' (debridement, antibiotics and implant retention): antibiotic duration and outcome. J Antimicrob Chemother. 2009;63:1264–71.
Blom AW, Brown J, Taylor AH, Pattison G, Whitehouse S, Bannister GC. Infection after total knee arthroplasty. J Bone Joint Surg Br. 2004;86:688–91.
Qasim SN, Swann A, Ashford R. The DAIR (debridement, antibiotics and implant retention) procedure for infected total knee replacement–a literature review. SICOT J. 2017;3:2.
Uckay I, Pittet D, Vaudaux P, Sax H, Lew D, Waldvogel F. Foreign body infections due to Staphylococcus Epidermidis. Ann Med. 2009;41:109–19.
Zurcher-Pfund L, Uckay I, Legout L, Gamulin A, Vaudaux P, Peter R. Pathogen-driven decision for implant retention in the management of infected total knee prostheses. Int Orthop. 2013;37:1471–5.
Tsumura H, Ikeda S, Ono T, Itonaga I, Taira H, Torisu T. Synovectomy, debridement, and continuous irrigation for infected total knee arthroplasty. Int Orthop. 2005;29:113–6.
Liu CW, Kuo CL, Chuang SY, Chang JH, Wu CC, Tsai TY, et al. Results of infected total knee arthroplasty treated with arthroscopic debridement and continuous antibiotic irrigation system. Indian J Orthop. 2013;47:93–7.
Johns BP, Loewenthal MR, Dewar DC. Open compared with arthroscopic treatment of acute septic arthritis of the native knee. J Bone Joint Surg Am. 2017;99:499–505.
Chung JY, Ha CW, Park YB, Song YJ, Yu KS. Arthroscopic debridement for acutely infected prosthetic knee: any role for infection control and prosthesis salvage? Arthroscopy. 2014;30:599–606.
Dixon P, Parish EN, Cross MJ. Arthroscopic debridement in the treatment of the infected total knee replacement. J Bone Joint Surg Br. 2004;86:39–42.
Raab GE, Jobe CM, Williams PA, Dai QG. Damage to cobalt-chromium surfaces during arthroscopy of total knee replacements. J Bone Joint Surg Am. 2001;83-A:46–52.
Smith DC, Maiman R, Schwechter EM, Kim SJ, Hirsh DM. Optimal irrigation and debridement of infected total joint implants with chlorhexidine gluconate. J Arthroplasty. 2015;30:1820–2.
Schwechter EM, Folk D, Varshney AK, Fries BC, Kim SJ, Hirsh DM. Optimal irrigation and debridement of infected joint implants: an in vitro methicillin-resistant Staphylococcus Aureus biofilm model. J Arthroplasty. 2011;26(6 Suppl):109–13.
Flood JN, Kolarik DB. Arthroscopic irrigation and debridement of infected total knee arthroplasty: report of two cases. Arthroscopy. 1988;4:182–6.
Ilahi OA, Al-Habbal GA, Bocell JR, Tullos HS, Huo MH. Arthroscopic debridement of acute periprosthetic septic arthritis of the knee. Arthroscopy. 2005;21:303–6.
Waldman BJ, Hostin E, Mont MA, Hungerford DS. Infected total knee arthroplasty treated by arthroscopic irrigation and debridement. J Arthroplasty. 2000;15:430–6.
Meehan AM, Osmon DR, Duffy MC, Hanssen AD, Keating MR. Outcome of penicillin-susceptible streptococcal prosthetic joint infection treated with debridement and retention of the prosthesis. Clin Infect Dis. 2003;36:845–9.
Freeman MA, Sudlow RA, Casewell MW, Radcliff SS. The management of infected total knee replacements. J Bone Joint Surg Br. 1985;67:764–8.
Parvizi J, Gehrke T, Chen AF. Proceedings of the international consensus on periprosthetic joint infection. Bone Joint J. 2013;95-B:1450–2.
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Miles, J., Parratt, M.T. (2018). Arthroscopic Debridement of Infected Total Knee Arthroplasty. In: RodrÃguez-Merchán, E., Oussedik, S. (eds) The Infected Total Knee Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-66730-0_16
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DOI: https://doi.org/10.1007/978-3-319-66730-0_16
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