XXXX following total knee arthroplasty. Ten-year experience at the University of California at Los Angeles Medical Center.

@entity1 @entity295 @entity1252 @entity281 @entity158
Between September 1971 and May 1982, at the University of California at Los Angeles Medical Center, 821 total knee arthroplasties were performed in 604 @entity1 , all of whom received perioperative antibiotics. @entity295 , proved by a positive culture of a specimen obtained by postoperative arthrocentesis, developed fourteen times in thirteen knees of twelve @entity1 , an incidence of 1.71 per cent. In one of these @entity1 , who had @entity1252 and bilateral knee replacement, the right knee became infected with two distinct organisms on two different occasions (separated by ten months). The first infection was probably hematogenous while the second, developing after a dental procedure, definitely was. Over-all, five @entity281 were hematogenous with an identified source and one other was suspected of having a hematogenous origin. The time from operation to the diagnosis of @entity295 averaged 8.3 months over-all, but five of the fourteen @entity281 were recognized less than two months after arthroplasty. For the six @entity281 that were assumed to be hematogenous, the time from operation to the diagnosis of @entity295 averaged 16.4 months. The major presenting symptom was @entity158 in thirteen of the fourteen @entity281 . The initial treatments of the fourteen @entity281 consisted of intravenous antibiotics in all of them, primary removal of the prosthesis and so-called exchange arthroplasty after five days in one, removal of the prosthesis and fusion in one, arthrotomy and d  bridement in six, arthroscopic irrigation in three, and antibiotics alone in three (of which one was treated with an exchange arthroplasty after three weeks). At last follow-up, only four of the thirteen prostheses had been salvaged.(ABSTRACT TRUNCATED AT 250 WORDS)
