Difficult-to-Detect Low-Grade Infections Responsible for Poor Outcomes in Total Knee Arthroplasty

Am J Orthop (Belle Mead NJ). 2017 May/Jun;46(3):E148-E153.

Abstract

In this article, we present the case of a patient with a stiff, painful knee after total knee arthroplasty, and with erythrocyte sedimentation rate, C-reactive protein level, and synovial fluid analysis within normal limits. Open biopsy for cultures showed Propionibacterium acnes prosthetic joint infection, which was successfully treated with 2-stage revision and intravenous antibiotics.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Gram-Positive Bacterial Infections / diagnosis*
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / etiology
  • Gram-Positive Bacterial Infections / microbiology
  • Humans
  • Knee Joint / microbiology
  • Knee Joint / surgery*
  • Male
  • Oxacillin / therapeutic use
  • Postoperative Complications / diagnosis
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology
  • Postoperative Complications / microbiology
  • Propionibacterium acnes / isolation & purification*
  • Prosthesis-Related Infections / diagnosis*
  • Prosthesis-Related Infections / drug therapy
  • Prosthesis-Related Infections / etiology
  • Prosthesis-Related Infections / microbiology
  • Reoperation
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Oxacillin