Bilateral knee prosthetic joint infection: a case report

Authors

  • Yasser M. Alharbi Department of Orthopaedic Surgery, Ministry of the National Guard-Health Affairs, Prince Mohammed Bin Abdulaziz Hospital, Medina, SAU
  • Ibrahim M. Alhumaidi Department of Orthopaedic Surgery, Ministry of the National Guard-Health Affairs, Prince Mohammed Bin Abdulaziz Hospital, Medina, SAU
  • Asim J. Alamri Department of Orthopaedic Surgery, Ministry of the National Guard-Health Affairs, Prince Mohammed Bin Abdulaziz Hospital, Medina, SAU
  • Rayan S. Jamal Department of Orthopaedic Surgery, Ministry of the National Guard-Health Affairs, Prince Mohammed Bin Abdulaziz Hospital, Medina, SAU

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20250643

Keywords:

Antimicrobial therapy, Culture negative prosthetic joint infection, Debridement and implant retention, Hematogenous spread, Infected total knee replacement, Infection recurrence, Prosthetic joint infection, Staged revision arthroplasty

Abstract

Bilateral prosthetic joint infection (PJI) is considered rare and its treatment can be challenging. We present this case report of a 70-year-old male with acute presentation of simultaneous bilateral knee prosthetic joint infection. Initially managed with debridement and implant retention with six weeks of intravenous antibiotics. Six months later presented with left knee pain and swelling with investigations showing left knee prosthetic joint infection and was taken for staged revision arthroplasty. Three weeks following staged revision surgery patient presented with left knee progressive pain and open sinus which then was taken for debridement and polyethylene exchange followed by six weeks of intravenous antibiotics. This case report highlights the prevalence, etiologies and risk factors of simultaneous bilateral PJI. Also discussing available treatment options, antimicrobial therapy durations and some encountered difficulties like infection recurrence.

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References

Izakovicova P, Borens O, Trampuz A.: Periprosthetic joint infection: current concepts and outlook. EFORT Open Rev. 2019;4:482-94. DOI: https://doi.org/10.1302/2058-5241.4.180092

Corvec S, Portillo ME, Pasticci BM, Borens O, Trampuz A.: Epidemiology and new developments in the diagnosis of prosthetic joint infection. Int J Artif Organs. 2012;35:923-34. DOI: https://doi.org/10.5301/ijao.5000168

Tai DBG, Patel R, Abdel MP, Berbari EF, Tande AJ.: Microbiology of hip and knee periprosthetic joint infections: a database study. Clin Microbiol Infect. 2022;28:255-9. DOI: https://doi.org/10.1016/j.cmi.2021.06.006

Gausden EB, Pagnano MW, Perry KI, Suh GA, Berry DJ, Abdel MP. Synchronous periprosthetic joint infections: high mortality, reinfection and reoperation. J Arthroplasty. 2021;36:3556–61. DOI: https://doi.org/10.1016/j.arth.2021.05.010

Arvieux C, Common H. New diagnostic tools for prosthetic joint infection. Orthop Traumatol Surg Res. 2019;105:23-30. DOI: https://doi.org/10.1016/j.otsr.2018.04.029

Cyteval C, Bourdon A.: Imaging orthopedic implant infections. Diagn Int Imaging. 2012;93:547-57. DOI: https://doi.org/10.1016/j.diii.2012.03.004

Lima AL, Oliveira PR, Carvalho VC, Saconi ES, Cabrita HB, Rodrigues MB. Periprosthetic joint infections. Interdiscip Perspect Infect Dis. 2013;5:42796. DOI: https://doi.org/10.1155/2013/542796

Parvizi J, Tan TL, Goswami K, Higuera C, Della Valle C, Chen AF, et al. The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria. J Arthroplasty. 2018;33:1309-14. DOI: https://doi.org/10.1016/j.arth.2018.02.078

Christensen DD, Moschetti WE, Brown MG, Lucas AP, Jevsevar DS, Fillingham YA. Dartmouth hitchcock medical center.: perioperative antibiotic prophylaxis: single and 24-hour antibiotic dosages are equally effective at preventing periprosthetic joint infection in total joint arthroplasty. J Arthroplasty. 2021;36:308-13. DOI: https://doi.org/10.1016/j.arth.2021.02.037

Aleeson E, Chen AF. Patient-related medical risk factors for periprosthetic joint infection of the hip and knee. Ann Transl Med. 2015;3:233.

Honkanen, Meeri.: Periprosthetic joint infections as a consequence of bacteremia. Open Forum Infect Dis. 2019;6:218. DOI: https://doi.org/10.1093/ofid/ofz218

Malekzadeh D, Osmon DR, Lahr BD, Hanssen AD, Berbari EF. Prior Use of Antimicrobial Therapy is a Risk Factor for Culture-Negative Prosthetic Joint Infection. Clin Orthop Relat Res. 2010;468:2039–45. DOI: https://doi.org/10.1007/s11999-010-1338-0

Berbari EF, Marculescu C, Sia I. Culture-negative prosthetic joint infection. Clin Infect Dis. 2007;45:1113–9. DOI: https://doi.org/10.1086/522184

Rakow A, Perka C, Trampuz A, Renz N. Origin and characteristics of haematogenous periprosthetic joint infection. Clin Microbiol Infect. 2019;25:845-50. DOI: https://doi.org/10.1016/j.cmi.2018.10.010

Zeller V, Dedome D, Lhotellier L, Graff W, Desplaces N, Marmor S. Concomitant Multiple Joint Arthroplasty Infections: Report on 16 Cases. J Arthroplasty. 2016;31:2564-8. DOI: https://doi.org/10.1016/j.arth.2016.02.012

Koyonos L, Zmistowski B, Della Valle CJ, Parvizi J.: Infection Control Rate of Irrigation and Debridement for Periprosthetic Joint Infection. Clin Orthop Relat Res. 2011;469:3043–8. DOI: https://doi.org/10.1007/s11999-011-1910-2

Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, et al. Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the infectious disease’s society of America. Clin Infect Dis. 2013;56:1–25. DOI: https://doi.org/10.1093/cid/cis803

Mahmud T, Lyons MC, Naudie DD, Macdonald SJ, McCalden RW. Assessing the gold standard: a review of 253 two-stage revisions for infected TKA. Clin Orthop Relat Res. 2012;470:2730–6. DOI: https://doi.org/10.1007/s11999-012-2358-8

Zmistowski B, Tetreault MW, Alijanipour P, Chen AF, Della Valle CJ, Parvizi J. Recurrent periprosthetic joint infection: persistent or new infection. J Arthroplasty. 2013;28:1486–9. DOI: https://doi.org/10.1016/j.arth.2013.02.021

Maheshwari AV, Gioe TJ, Kalore NV, Cheng EY. Reinfection after prior staged reimplantation for septic total knee arthroplasty: is salvage still possible. J Arthropl. 2010;25:92–7. DOI: https://doi.org/10.1016/j.arth.2010.04.017

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Published

2025-02-28

How to Cite

Alharbi, Y. M., Alhumaidi, I. M., Alamri, A. J., & Jamal, R. S. (2025). Bilateral knee prosthetic joint infection: a case report. International Journal Of Community Medicine And Public Health, 12(3), 1488–1492. https://doi.org/10.18203/2394-6040.ijcmph20250643

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Section

Case Reports