Two-Stage Exchange for Infected TKA-Opposes

Treatment of sepsis in total joint arthroplasty traditionally has entailed implant removal, debridement, and a 6-week course of intravenous antibiotics in tandem with antibiotic-laden cement beads or spacer before revision arthroplasty. This technique generally has been successful, but, in patients with resistant organisms, the local levels of antibiotics needed to treat resistant organisms cannot be maintained with these measures. This article describes a technique for intraarticular infusion of antibiotics with Hickman catheters and reviews the results in three series of patients. Direct intraarticular infusion technique was found to maintain high antibiotic levels in the joint and therapeutic levels in the serum.