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LAHAINA, Hawaii 2008 – Of the several treatment options for infections in total knee replacements, reimplantation may offer the best functional outcome along with a high degree of infection control.

“The infection rate [in total knee replacement] over the past three decades has diminished, but I think it remains one of the most difficult problems to manage. Once a patient has a periprosthetic infection, the outcome for that patient – both in the infection [cure] rate and overall patient functionality – is nothing like a primary TKR,” said Robert T. Trousdale, MD, of the Mayo Clinic in Rochester, Minn…

…One of the current controversies surrounding infection control concerns the timing of staging prior to performing reimplantation when the components are debrided or resected…

…”At the Mayo Clinic, we often use antibiotics for 4 to 6 weeks, then a 2- to 3-week antibiotic ‘holiday,’ followed by a restaging to make sure that there isn’t an infection. When that’s done, we do the reimplantation,” he said.

Antibiotic spacers can be effective for select patients, according to Trousdale. “We also use cement with antibiotics in all of our revision cases,” he said.