The Epidemiology and Diagnosis of Infection After Total Knee Arthroplasty

Abstract

 According to the official arthroplasty registries the rate of revision after total knee arthroplasty (TKA) in Japan is lower in comparison to Australia, New Zealand, or the United States. The rate of infection after TKA is about 1% and it is almost the same in the aforementioned countries. According to the previous reports, the rate of infection after TKA for rheumatoid arthritis of the knee has been 1.6 to 3 times higher compared to TKA for osteoarthritis of the knee.

 The document “Proceedings of the International Consensus Meeting on Periprosthetic Joint Infection” was presented as a guide to clinicians who treated patients with periprosthetic joint infection (PJI) in 2013. This definition was reported to have high specificity and moderate sensitivity for PJI. In 2018, new diagnostic criteria were developed, and that showed high sensitivity and specificity for PJI.

 Gram staining of joint fluid is considered to be of limited value in the diagnosis of septic arthritis or infection after TKA owing to its low sensitivity to identify bacteria. We evaluated the sensitivity of the Gram stain of aspirated joint fluid in patients with septic arthritis or infection after TKA in our hospital. The sensitivity of Gram staining of joint fluid was 96%.

 Gram staining of aspirated joint fluid appears to be a reliable method for the diagnosis of knee joint infection.