Infectious Complication of Revision Knee Replacement

Abstract

The article presents the case of the patient having an infectious complication in the area of the endoprosthesis after performing revision knee replacement. Revision surgery was performed six months after the primary knee replacement due to the instability of the components of the endoprosthesis. In analyzing the case of an infectious complication, a six-point risk factor for the development of infectious complications was given taking into consideration the following factors: body mass index; ASA physical status evaluation; the presence of diabetes mellitus, concomitant systemic diseases; the presence of allergic reactions; the presence of previous operations on the joint; index of the ratio of segmented neutrophils and monocytes. The analysis made it possible to establish that the patient had a high risk of infectious complications before the surgery of the endoprosthesis replacement and determine the list of necessary preventive and therapeutic measures (glycemia correction, bacteriological examination of the knee joint puncture, rehabilitation of existing and possible foci of chronic infection, examination and treatment at the center of osteoporosis) that had not been held. The implementation of surgical treatment - revision knee replacement - against the background of a high risk of infectious complications led to the development of the infectious process. To stop the infection process, surgical treatment was performed, including necrectomy, debridement, drainage of the knee joint, without removing the components of the endoprosthesis. Remission was achieved. The clinical case of an infectious complication of revision knee arthroplasty is of interest, as it shows the importance of assessing adverse prognostic factors, establishing the degree of risk of infectious complications, and conducting the necessary preventive and therapeutic measures in the preoperative period to reduce the risk of developing an infectious process in the endoprosthesis area.