Abstract:

BACKGROUND: Periprosthetic infection remains one of the most devastating and costly complications after total knee replacement. It is very important for the prognosis of total knee replacement that understanding its pathogenesis, make an accurate diagnosis timely, and to develop the appropriate treatment.
OBJECTIVE: To summarize the research progress regarding pathogenesis, diagnosis and treatment of infections after total knee replacement.
METHODS: A computer-based online search of CNKI between January 1982 and December 2009 and PUBMED database was performed to search related articles with the key words of “total knee arthroplasty; infection”. A total of 2 673 articles were retrieved. Moreover, related works were manually searched. Totally 34 articles were included. 
RESULTS AND CONCLUSION: The biofilm on phantom surface protects the microbiologic not eradicated by antibiotics. Blood tests, bacteriological culture and imaging are effective procedures for the diagnosis of total knee replacement. But they all have disadvantages, which should be considered. Currently, the treatment modalities of total knee replacement are antibiotics, debridement and prosthesis retention, thorough debridement and one or two-stage reimplantation, arthrodesis, disarticulation and other treatments. The orthopaedic surgeon uses an essential armamentarium of diagnostic and treatment options to determine the presence of infection and tailor the individual treatment for each patient.