[Infected knee prostheses. Part 1: early infection or acute hematogenous infection].

OBJECTIVE: Treatment of an early total knee arthroplasty (TKA) infection with the goal of salvaging the implant. INDICATIONS: Early postoperative infections within the first 4 weeks. The acute hemtogenous infection of the knee joint with TKA and duration of symptoms for a maximum of 4 weeks. CONTRAINDICATIONS: Unsuitable for anesthesia, high acute infection with sepsis and risk for bacteremia with danger to life, large soft tissue damage where plastic surgery coverage is not possible. SURGICAL TECHNIQUE: Arthrotomy, synovectomy, inlay removal, jet lavage, instillation of polyhexanide, new inlay, drainage and infusion-aspiration-drainage if necessary, wound closure with plastic surgery if necessary. POSTOPERATIVE MANAGEMENT: Infusion-aspiration-drainage with polyhexanide for 3 days or drainage for 3 days. Continuous passive motion (CPM) with increasing range of motion (ROM) 0-0-30°. Removal of the drain after 5 days and mobilization with increasing ROM and full weight-bearing.
RESULTS: The success rate for the salvage procedure is about 70%.