Sarzaeem Mohammad Mahdi, Feizi Davood, Jamshidi Kouhsari Hamidreza, Amouzadeh Omrani Farzad, Pourmojarab Ali
Department of Orthopaedic Surgery and Traumatology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arthroplast Today. 2025 Jul 28;34:101777. doi: 10.1016/j.artd.2025.101777. eCollection 2025 Aug.
We present three cases of acute septic arthritis in osteoarthritic knees managed with one-stage primary total knee arthroplasty and followed for 2 years. This approach, diverging from conventional staged protocols, combines thorough debridement, immediate biomechanical restoration, and extended antibiotic therapy. Patients exhibited significant symptomatic relief, functional recovery, and no recurrent infections. Literature supports the efficacy of single-stage revisions in chronic periprosthetic infections, yet its application to acute septic arthritis remains underexplored. Our findings highlight the importance of meticulous patient selection, considering host immunity, microbial virulence, and comorbidities. One-stage total knee arthroplasty offers a viable, streamlined alternative for well-selected patients, mitigating the morbidity of multiple surgeries and protracted recovery.
我们报告了3例骨关节炎膝关节急性化脓性关节炎患者，采用一期初次全膝关节置换术治疗，并随访2年。这种方法与传统的分期方案不同，它结合了彻底清创、立即进行生物力学修复和延长抗生素治疗。患者症状明显缓解，功能恢复，且无反复感染。文献支持单阶段翻修术治疗慢性假体周围感染的疗效，但其在急性化脓性关节炎中的应用仍未得到充分探索。我们的研究结果强调了仔细选择患者的重要性，要考虑宿主免疫力、微生物毒力和合并症。对于精心挑选的患者，一期全膝关节置换术提供了一种可行、简化的替代方案，可减轻多次手术的发病率和延长恢复时间。
