Delayed onset of deep infection after total knee arthroplasty: comparison based on the infecting organism

S Joshy, N Gogi, B Thomas, A Mahale, BK Singh
Department of Orthopaedics, City Hospital, Birmingham, United Kingdom

PURPOSE. To identify the organisms causing delayed
deep infection following primary total knee
arthroplasty (TKA) and to compare the differences in
outcome based on the infecting organism.

METHODS. Between the period April 1998 and March
2004 inclusive, patients presenting with delayed
deep infection following primary TKA and/or those
who underwent a salvage procedure (amputation or
arthodesis) were retrospectively studied.

RESULTS. Organisms were isolated in 27 patients; 44%
were methicillin-resistant Staphylococcus aureus and
Staphylococcus epidermidis. When the organism was
resistant, the mean number of surgical procedures per
patient was significantly higher and the proportion of
patients with satisfactory outcomes was significantly
lower.

CONCLUSION. Deep infection with methicillin-resistant
S aureus or S epidermidis is increasing. Strict infection
control measures must be in place to combat such problems.