Direct Intra-Articular Antibiotic Infusion for Resistant Organisms in the Treatment of Infection in Joint Arthroplasty

Infected total knee arthroplasty treated with 2-stage revision, intravenous antibiotics, and an antibiotic spacer has a high rate of failure, especially in cases with resistant organisms or reinfection. An aggressive regimen that includes extensive exposure, meticulous debridement, soft-tissue reconstruction, cementless fixation of porous-coated implants, and direct intra-articular delivery of antibiotics has been developed to treat these difficult cases. A brief review of a clinical series of 18 cases is presented with a 94% rate of success in controlling the infection and achieving a well-fixed arthroplasty.