# 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

**Authors:** Mohammad Mahdi Sarzaeem, Davood Feizi, Hamidreza Jamshidi Kouhsari, Farzad Amouzadeh Omrani, Ali Pourmojarab

PMC · DOI: 10.1016/j.artd.2025.101777 · Arthroplasty Today · 2025-07-28

## TL;DR

This paper explores using one-stage total knee replacement to treat severe knee infections in patients with arthritis, showing promising results in recovery and infection prevention.

## Contribution

The study introduces one-stage primary total knee arthroplasty as a novel treatment for acute septic arthritis in osteoarthritic knees.

## Key findings

- Patients experienced significant symptomatic relief and functional recovery.
- No recurrent infections were observed in the 2-year follow-up period.
- One-stage arthroplasty is a viable alternative for well-selected patients.

## Abstract

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.

## Full-text entities

- **Genes:** CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}
- **Diseases:** Septic Arthritis (MESH:D001170), DJD (MESH:D019636), non-insulin-dependent diabetes mellitus (MESH:D003924), diabetes (MESH:D003920), erythema (MESH:D004890), hypertension (MESH:D006973), RA (MESH:D001172), arthritis (MESH:D001168), TKA (MESH:D007718), knee pain (MESH:D046788), PJIs (MESH:D057068), fungal arthritis (MESH:D009181), inflammatory (MESH:D007249), impaired ambulation (MESH:D020233), end-stage renal disease (MESH:D007676), infected (MESH:D007239), malalignments (MESH:D017760), cirrhosis (MESH:D005355), infectious disease (MESH:D003141), infected TKA (MESH:D000092443), effusion (MESH:D000080324), chronic obstructive pulmonary disease (MESH:D029424), a restricted range (MESH:D002313), joint destruction (MESH:D008105), fever (MESH:D005334), swelling (MESH:D004487), motion (MESH:D009041), leukocytosis (MESH:D007964), intra-articular infection (MESH:D057072), ischemic heart disease (MESH:D017202), necrotic (MESH:D009336), pain (MESH:D010146), PJI (MESH:C537702), sepsis (MESH:D018805), inability to bear (MESH:C565129), Osteoarthritis (MESH:D010003)
- **Chemicals:** Anti-rheumatoid (-), metformin (MESH:D008687), tobramycin (MESH:D014031), aspirin (MESH:D001241), meropenem (MESH:D000077731), povidone-iodine (MESH:D011206), polymethyl methacrylate (MESH:D019904), clindamycin (MESH:D002981), methotrexate (MESH:D008727), gliclazide (MESH:D005907), losartan (MESH:D019808), gentamicin (MESH:D005839), steroid (MESH:D013256), prednisolone (MESH:D011239), atorvastatin (MESH:D000069059), vancomycin (MESH:D014640), tiotropium (MESH:D000069447), Methicillin (MESH:D008712), bisoprolol (MESH:D017298), rifampin (MESH:D012293), hyaluronic acid (MESH:D006820)
- **Species:** Homo sapiens (human, species) [taxon 9606], Staphylococcus aureus (species) [taxon 1280]

## Full text

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## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12320547/full.md

## References

24 references — full list in the complete paper: https://tomesphere.com/paper/PMC12320547/full.md

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Source: https://tomesphere.com/paper/PMC12320547