The Investigation and Management of Peri-Prosthetic Joint Infection After Total Knee Arthroplasty: An Update Based on the Latest British Orthopaedic Association Standard and Speciality Standard Guidelines

Abstract

Peri-prosthetic joint infection (PJI) is a significant complication following total knee arthroplasty (TKA). Early identification and management are essential to prevent severe morbidity and mortality in these patients. Long-term complications of PJI include the need for multiple operations, disability, joint stiffness, reduced range of motion, and increased mortality. Clinical signs, inflammatory markers, imaging, tissue sampling, and synovial fluid analysis are required to diagnose PJI. Debridement antibiotics and implant retention (DAIR) is an effective management option, but single- or two-stage exchange arthroplasty may be ultimately required. All cases of PJI in TKA must be discussed in a multi-disciplinary (MDT) meeting. This review incorporates the updated British Orthopaedic Association (BOA) standard and speciality standard to provide an up-to-date guideline on the early identification and management of PJI. We highlight that adhering to the BOA guidelines and adopting an MDT approach are essential for optimal patient outcomes. Copyright © 2024, Doski et al.