Open AccessRecurrent Prosthetic Knee Infection Associated with a Hidden Nidus in the Quadriceps Tendon
Author(s) -
Joao Pedro Gouveia Nobrega,
Fábio Marcos de Sousa,
Carla Sofia Vieira Brazão,
João Pedro Pereira,
Paulo Henrique F. Dourado
Publication year - 2022
Publication title -
sas journal of medicine
Language(s) - English
Resource type - Journals
ISSN - 2454-5112
DOI - 10.36347/sasjm.2022.v08i01.007
Subject(s) - medicine , debridement (dental) , quadriceps tendon , surgery , perioperative , soft tissue , tendon , knee joint , diabetes mellitus , endocrinology
We present a case of a 60-year-old male with poorly controlled type 2 Diabetes that had recurrent prosthetic knee infection that besides antibiotic or surgical treatment was difficult to treat. On the latest revision, he presented with an infection of the knee spacer with severe stiffness impairing knee flexion. In the debridement phase, we noticed a nidus of purulent tissue on the quadriceps tendon hidden inside an apparently normal peritendon. This case highlights several management details to avoid recurrent catastrophic prosthetic knee infection recurrence such as: the importance of perioperative management of comorbid diseases such as hyperglycaemia and poorly controlled diabetes that are a well-defined evidence-based risk factor for prosthetic joint infection and also the importance of adequate debridement as a balanced surgical gesture between excising too little or too much not to damage the soft tissue envelope.