Your perception of the overall worth of life can change after a knee infection. Modern surgical techniques in treating osteoarthritic joints have drastically changed the post operative outcome and hence the chances of any surgical infections are tremendously minimal. Despite these advances, it is important to focus on the management of knee infections which includes strategies, symptoms, and treatment so that the best practices might be achieved.
For more information on this problem and on how the knee can be addressed as well as treated for such complications, Dr. Simon Thomas, an advanced orthopedic surgeon specializes in reconstructive surgery procedures at Max Hospital, New Delhi.
What Is Knee Infection?
A knee infection is a microorganism inside the knee joint space which becomes acute or chronic. Knee replacement infections are not so frequent but when they do occur, it can be quite serious and may need immediate attention. Infections can generally be classified into two categories:
- Septic Arthritis also called ‘acute infectious joint disease’ – The septic condition in which inflammation of the joint (the knee in this case) occurs due to a septic process – mainly bacterial, in the joint or in the synovium surrounding the joint. This is due to the entry of microorganisms into the joint space as a result of traumatic injuries, surgical operations or bacteremia.
- Periprosthetic Joint Infection (PJI): This type of knee infection occurs around a replaced knee joint, where bacteria infect the surrounding tissues or the implant itself.
Causes of Knee Infections
Some of the factors that cause knee infections are:
- Open Injuries: A cut and other injuries around the knee joint assist in the entrance of bacteria.
- Compromised Immunity: Individuals who have their immune responses compromised due to diabetes or undergoing any other treatment are more at risk for infections.
- Post-Surgical Infections: There is a risk of infection with any form of surgery, including a total knee replacement. Inadequate wound management and contamination of wounds during the procedure can precipitate knee replacement infections.
What is Knee Replacement Infection?
A knee replacement infection also known as Periprosthetic Joint Infection (PJI) is a type of infection that affects the tissues surrounding the prosthesis. Even though enormous improvements have been made in techniques of knee replacement surgery and postoperative management of the patients, there is still a possibility of knee replacement infections resulting from:
- Pre-existing Infections: Surgeons do advise that dental infections, urinary tract infections and other active infections be treated first before any knee replacement surgery is done as they pre-dispose the patients to knee replacement infection after surgery.
- Immunocompromised Patients: It is notable that most of such patients suffer from chronic conditions such as diabetes, anachronistic conditions as post operative infections are quite common among them patients.
- Improper Wound Care: Though complications of knee replacement surgery are quite common, most of them are injury-induced complications that can be prevented if postoperative care is adhered to.
Symptoms of Knee Replacement Infection
It is essential to ensure that signs of knee infection are recognized early in order to manage situations effectively. Some symptoms are:
- Increased Pain: Sudden increase in joint pain can be a possible infection within the joints. Accompanied to this pain there is also the presence of loss of motion or stiffness.
- Swelling and Redness: If the knee joint becomes swollen and red, consult a specialist.
- Stiffness: Trouble straightening or bending the knee, which was normally functional, may indicate the presence of infection.
Nevertheless, an important thing to highlight is the fact that not every pain and stiffness episode means that one has an infection. Visit an experienced joint replacement specialist such as Dr. Simon Thomas.
Best Strategies To Avoid Infection After Surgery
Despite the fact that the possibility of developing an infection following knee replacement surgery is very low, taking some precautions will help to make it even less likely to develop PJI. Below, some of the most critical infection control measures are outlined:
- Maintain Good Hygiene: As far as infections are concerned, maintaining cleanliness in the surgical site post operatively is of utmost importance. For instance, free from excess moisture and dressing after the surgery when the incision is healing.
- Control Chronic Conditions: Patients suffering from diabetes, hashimoto’s disease or any other chronic conditions need to collaborate with their physicians to optimize their health prior to undergoing any operation. More than any other chronic conditions, diabetic patients need to maintain their blood sugars as much as they can.
- Repair Infection Before Surgery: Particular infections for example dental or UTI, need to have been cleared in their entirety before having knee surgery. Such patients should let their doctor know regarding these problems beforehand.
- Antibiotic Prophylaxis: Under specific conditions, patients may be prescribed antibiotics prior to surgery to decrease the chances of getting infected.
Treatment Options for Infection After Knee Replacement Surgery
Knee infection treatment is possible, and in most cases, the earlier the intervention the better. Depending on the degree of infection, treatment options include the following:
- DAIR Procedure (Debridement, Antibiotics, and Implant Retention)
Detecting a knee replacement infection early on can help one manage it without having to take out the knee implant. Removal of infective tissue from the surrounding areas without replacing the prosthesis is called DAIR procedure. After successful treatment, patients can feel a normal joint function returning.
- Two-Stage Revision Surgery
It is a very effective procedure with nearly 100% success rate and a very low risk of reinfection.
The surgery is performed in two stages:
- Stage 1: The infected joint is excised and a mobile antibiotic spacer is positioned within the joint recess. Patients can walk and undertake personal activities with it.
- Stage 2: A more traditional knee implant is affixed at the time of the second stage after resolving the infection completely.
- One-Stage Revision Surgery
In certain instances, One-Stage Revision Surgery can be used judiciously for certain patients. Patients undergoing this surgery will have their infected implants removed and new implants will be fixed on the same procedure. This method is effective in getting rid of the infection and eliminating the need for a second surgical procedure.
Conclusion
Knee Infection, even if rare, is considered one of the most troublesome complications and requires appropriate measures in a timely manner. A wise approach would be to keep good hygiene and control chronic diseases such as diabetes. Also, any other sources of infection such as dental infections or urinary tract infections need to be resolved before an individual undergoes a knee replacement.
Whether you’re dealing with a mild infection or require complex revision surgery, Dr. Thomas and his team are equipped to handle all aspects of knee replacement care, ensuring that you get the best treatment.