Total knee arthroplasty in patients with prior adjacent multi-organism osteomyelitis

Abstract

Joint degeneration may make a total knee replacement a requirement for pain relief and function, however the presence of adjacent osteomyelitis makes management extremely challenging. We describe a series of four patients with a mean age of 50 with multi-organism osteomyelitis who underwent single- stage total knee replacements at an average of 63 months following eradication. Three patients did well but had complications associated with poor skin and soft tissues, and abnormal bone anatomy. One patient developed an infection and following a re-revision had an arthrodesis. The final mean Knee Society Score and Oxford Knee Score was 62 (54-66) and 34 (29-38) respectively. We have highlighted that these are a difficult cohort of patients to manage and their care is optimised through a multi-disciplinary approach by a high volume surgeon.