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Infected old Knee Replacement – 2 stage Revision Knee Replacement

2 Stage Revision is the GOLD Standard Treatment in cases of Infected knee Replacement

74 year old gentleman had a knee replacement done elsewhere 1 year ago for Knee pain.

After 1 year of surgery patient came to Laud Clinic with severe pain and excess warmth over his operated knee. He was unable to walk with the knee.

Xrays suggested loosening of the Implants. Local Warmth over the knee, Pain and restricted movements suggestive of infection of the knee joint. Blood Investigation suggested raised Inflamatory markers.

Knee Aspiration was done in OT and Fluid sent for Culture & Sensitivity.

With positive reports patient planned for 2 stage revision surgery

Stage 1- Infection removal

Knee Joint was opened and old Implants removed ,Infected tissue removed & thorough wash with sterile saline with Pulsative lavage technology given and Antibiotic Impregnated Cement spacer put which will deliver high concentration of Antibiotic (as per culture sensitivity from earlier knee aspiration) over the next few weeks. IV Antibiotics as per sensitivity given for 6 weeks .

Then patient kept with Antibiotic free period of minimum 6 weeks in which period he was observed for signs of reappearance of Infection.

During this period patient was able to perform his day to day activities at home, mobilizing with knee brace and walker support.

Stage 2 – Revision Knee Replacement

After clinical evaluation and serial blood, investigations suggest that infection is under control. The Antibiotic Spacer was removed and the new Revision Joint was put.

Patient was started knee movements on the same night of surgery and was made to stand putting equal load on both legs and was started to walk from the very next day after surgery.

He has been following up at Laud Clinic yearly for past 5 years after the surgery and there is no problems/recurrence of infection.

He has good Knee movements and goes for regular morning walk without any issues.