One-Stage Primary Total Knee Arthroplasty as the Treatment of Acute Septic Arthritis of the Native Osteoarthritic Knee: Report of 3 Cases and Review of Literature.

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.