Haematogenous infection of a prosthetic joint

: Prosthetic joint infection (PJI) is a major complication after total joint arthroplasty. The most common source of these PJIs is a wound infection immediately after implantation of the artificial joint; however, haematogenous infection is also a common source of PJIs. We describe 3 patients, all suffering from (rheumatoid) arthritis, who presented at the emergency department with a wound on the foot or ankle and a swollen and painful prosthetic knee joint, which was functioning well for a long period of time (6 months to 5 years). All patients had several debridements of their infected total knee arthroplasty with local and systemic antibiotics. Patient outcome was widely diverse: from death to successful treatment. These case descriptions are good examples of the different outcomes from a major complication after a small wound. Care should be taken particularly for wounds around the foot and ankle in patients with a total joint arthroplasty, especially those who also have diabetes, rheumatoid arthritis or are immunocompromised.