2 Cases Demonstrating Early Stage Deep Infection after Total Knee Joint Replacement

Of the TKR (total knee replacement) cases we experienced in this department up tp 1995, 2 (1.5%) were complicated with an MRSA infection. In both cases, curettage of the lesion and continuous irrigation were conducted immediately arter the infection was diagnosed. In one case which demomstrated loosening of the implants, removal of the implants and artrodesis were necessary. However, we succeeded in suppressing the early infection and retaining the implants in the other case in which loosening did not occur.Factors accelerationg infection were assumed to be insufficient contral of the reticular gland which was the site of wire traction in the tibial tubercle and plural surgery duting the same hospitalization period in Case 1 and decreased defence function against local infection attributable to frequent steroid injections and marked anemia and hypoproteinemia after surgery in Case 2.The advantage of povidone odine is that it demonstrates action against bacteria including MRSA as wellas fungi and viruses of and it does not acquire bacterial resistance. Its toxicity in bone, cartilage and soft tissue is negligible. Compared with other disinfectants, its bacterididal action is strong and it inexpensive.We conchided that 0.1% povidone iodine solution was effective when utilized in continuous irrigation.