Using an Algorithm to Choose the Surgical Tactics for the Treatment of Periprosthetic Infection of Large Joints

Assessing risks of developing and persistence of infectious process in knee joint replacement

Despite of intensive work on improving endoprosthetic replacement constructions, using minimally invasive techniques, developing methods of prevention for and treatment of periprosthetic joint infection, relapse of infection process can reach up to 52 % after treatment.The aim of the study: to show the importance of identifying the risks of development and recurrence of periprosthetic infection after implantation of a knee joint endoprosthesis. A clinical case of the development of a deep periprosthetic infection in a patient after primary knee replacement and successful treatment of the resulting complication was demonstrated. The analysis of this case of an infectious complication using the proposed prognosis for the development of periprosthetic infection showed that before surgical treatment of the patient, the risk of an infectious process was not assessed, and appropriate preventive and therapeutic measures were not carried out.Materials and methods. In the treatment of developed periprosthetic infection of the knee joint, the author’s algorithm for choosing surgical tactics was used, which allowed to determine the high risk of recurrence of periprosthetic infection, evaluate additional criteria and choose the optimal type of surgical intervention – two-stage revision endoprosthetic, which allowed to stop the infectious process.New was the use of the proposed prognosis for the development of periprosthetic infection and the algorithm for choosing surgical tactics for periprosthetic infection, which make it possible to determine the necessary preventive measures to reduce the risk of an infectious complication and to apply the optimal type of surgical intervention to relieve periprosthetic knee infection.