Infected total knee arthroplasty treated by arthroscopic irrigation and debridement

Sixteen patients with infected rural knee arthroplasties (4 postoperative a nd 12 late hematogenous) were treated by arthroscopic irrigation and debrid ement. All patients had less than or equal to 7 days of knee symptoms, and there were no radiographic signs of osteitis or prosthetic loosening. Six o f the 16 original total knee arthroplasties (38%) did nor need prosthesis r emoval at a mean follow-up of 64 months (range, 36-151 months). Ten other k nees were treated with irrigation, debridement, and hardware removal within 7 weeks of the latest procedure used to try to retain components. Two (13% ) of these cases ultimately required an arthrodesis for persistent infectio n. Although we still believe that this method is preferable to resorting im mediately Ir, implant removal for acute infections, arthroscopic debridemen t was less efficacious for most situations when compared with open treatmen t. We would use arthroscopic irrigation and debridement only under selected circumstances (medically unstable or anticoagulated patients).