Loosening of total knee arthroplasty – always aseptic?

Abstract Purpose When revision surgery is needed in total knee arthroplasty (TKA) the most frequent reasons are aseptic loosening (AL) and periprosthetic joint infection (PJI). However preoperative distinction between AL and PJI remains challenging. Aim of this study is to determine the incidence of...

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Bibliographic Details
Published in:Journal of clinical orthopaedics and trauma 2020-03, Vol.11 (Suppl 2), p.S234-S238
Main Authors: Schiffner, E, Latz, D, Karbowski, A, Grassmann, J.P, Thelen, S, Windolf, J, Jungbluth, P, Schneppendahl, J
Format: Article
Language:English
Subjects:
Aseptic loosening
Knee
Knee arthroplasty
Orthopedics
Periprosthetic joint infection
Primary Knee Arthroplasty
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Summary:Abstract Purpose When revision surgery is needed in total knee arthroplasty (TKA) the most frequent reasons are aseptic loosening (AL) and periprosthetic joint infection (PJI). However preoperative distinction between AL and PJI remains challenging. Aim of this study is to determine the incidence of PJI in patients with suspected AL after TKA and to evaluate a diagnostic algorithm for reliable differential diagnosis. Methods In this study a total of 149 symptomatic patients with radiographic signs of prosthetic loosening and suspected AL were included. Preoperatively all patients underwent a standardized diagnostic algorithm. For each patient demographics, as well as the results of laboratory and microbiological testing were collected from the medical records. Results Of the included patients 117 (78.5%) were diagnosed with AL and 32 (21.5%) with PJI. The latency period from primary arthroplasty to the presentation with symptomatic implant loosening was significantly shorter for PJI compared to AL (p 
ISSN:0976-5662
2213-3445
DOI:10.1016/j.jcot.2019.05.001