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A knee replacement loosened after 2 years and the follow-up

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Orthopaedic Surgeon
Practicing since : 1983
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A knee replacement loosened after 2 years and the follow-up revision was identified has having loosened after 2nd surgery in 2011. The tests in the last 6 years show CPR and ESR elevated to double the top limit indicated by the LAB. Recent aspiration results show neutrophils at 95% and 88% - Gram stain 4+ positive WBC and +1 RBC. Haemoglobin 62 to 95 variable. No antibiotics as yet but I suspect they need to finish their tests to identify the bacteria and and determine the most effective meds. Recent radiology indicates considerable bone loss/damage at the proximal tibia platform. To date specialists are considering if and when to do surgery. Your thoughts on the results of the aspiration? would be appreciated.
Posted Mon, 27 Nov 2017 in Bones, Muscles and Joints
 
 
Answered by Dr. Gopal Goel 36 minutes later
Brief Answer:
Appears to be infection, needs debridement.

Detailed Answer:
Hi, I am Dr Gopal Goel Orthopedic Surgeon.

I have read the details and in my opinion, most likely your replaced knee is infected with Gram + ve bacteria and raised CRP + ESR. Also the knee is loosened as per X rays.

I would prefer to start treatment ASAP with broad spectrum antibiotic and Knee debridement( removal of implant + cleaning of all affected tissues ). I would advice to change the antibiotics later depending on culture and sensitivity report.

Please consult your orthopedic surgeon immediately and get the proper treatment.

Please feel free to ask any other question.
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