This is Part 2 of a series of articles on threats to a proper knee surgery recovery. In this installment we discuss infection and knee replacement. I encourage you to explore the other articles which you can find by clicking on the link below.

So let’s get started. There are two types of infections to think about when it comes to knee replacement: ‘Superficial’ and ‘Deep’.

After knee replacement surgery, it’s possible to develop an infection in the incision. Doctors call these superficial, minor, or early-onset infections. Superficial infections usually occur soon after your surgery. You may develop a minor infection in the hospital or when you go home. The treatment is simple, but a minor infection can lead to a major one if it’s not treated.

You can also develop an infection around your artificial knee, also called a prosthesis or implant. Doctors call these deep, major, delayed-onset, or late-onset infections. Deep infections are serious and can occur weeks or even years after your knee replacement surgery. The treatment may involve several steps. You may need surgery to remove the infected artificial knee.

A knee replacement infection may develop in the wound after surgery. It may also occur around the artificial implant that is used to replace the knee joint. Harmful bacteria entering the wound usually cause the infection.

A knee replacement infection can occur any time after surgery. For instance:

In a study by the American Academy of Orthopaedic Surgeons, only 1%, one in every 100 people who have a hip or knee replacement, will develop an infection.

It may be evident to a surgeon that there is an infection in the knee with a simply visual inspection. There are tests that can be conducted to validate the presence of infection as you can see here:

For more on how to diagnose a knee infection click here: Diagnosing a Knee Infection

Richie got an infection in his knee during total knee replacement. He tells the full story in the video below.

Bacteria might enter a person’s body through the wound where the surgical incision was made, after knee replacement surgery. If bacteria reach a person’s new artificial knee joint, they may multiply and cause an infection.

Some bacteria are harmless (think of as those that occur naturally in the stomach) while others may harm a person and cause an infection. Your immune system most likely will kill any harmful bacteria that get into the bloodstream.

With a knee replacement, the knee joint is replaced with an artificial joint made of metal and plastic. Because these materials are not organic, it is harder for the body to kill bacteria on them.

Anyone who has a knee replacement can develop an infection after surgery, but some groups are at a greater risk of infection. These include people who:

There are many treatments for a knee replacement infection, including both nonsurgical and surgical procedures.

Some knee replacement infections are superficial, which means that the infection has reached the skin and tissue around the joint but does not affect the artificial joint itself. A superficial knee replacement infection may be treated with oral or intravenous (IV) antibiotics.

If a knee replacement infection goes deeper than the skin and tissue around a joint, it may need to be treated surgically, as follows:

Details on a Staged Surgery:

In a 2015 study (TREATMENT OF INFECTION AFTER TOTAL KNEE ARTHROPLASTY) it was concluded that: “the success rate in debridement plus prosthesis retention (debridement and retention of the prosthesis), one-stage and two-stages revision was 75%, 83.3% and 100%, respectively. The best results of quality of life and functional outcome, according to the SF-36 and WOMAC, occur in patients undergoing debridement and retention of the prosthesis as compared to the other treatments. In contrast, the worst quality of life and functional results were obtained in patients treated with two-stages revision arthroplasty” which is debridement and then a later replacement of the prosthesis. So it is better to treat the infection and keep the existing joint vs. starting all over again.

Below is a short video from Dr. Paul Zalzau and Dr. Brad Weening (www.talkingwithdocs.com) which is an easy way to get smart about knee infection

Before and during knee replacement surgery, the following steps may help reduce the risk of infection:

After knee replacement surgery, you may help reduce the risk of infection by:

Remember what I said at the beginning of this article. Only 1% of hip and knee patients are diagnosed with an infection. So please do not stay up at night worrying about infection… the odds are certainly with you. That said, be smart, protect yourself, choose a hospital and surgeon with a low (or nonexistent) infection rate. And pass this article on to anyone you know who has a knee surgery upcoming. The more we take care of each other, the better off we will all be.

CLICK TO DOWNLOAD THIS ARTICLE.

We call it a “Meta-Blog.” In these articles we step back and give you a broad perspective on all aspects of knee health. We explore surgery and recovery and such subjects as ‘Infection and Knee Replacement’.

This is a one-of-a-kind blog. We gather together great thinkers, doers, and writers. And it is all related to Knee Surgery, Recovery, Preparation, Care, Success and Failure. Meet physical therapists, coaches, surgeons, and patients. And as many smart people as we can gather to create useful articles for you. You may have a surgery upcoming. Or in the rear-view mirror. Maybe you just want to take care of your knees to avoid surgery. In all cases you should find some value here. Executive Editor: PJ Ewing ([email protected])