Management of Periprosthetic Total Knee Infection with Partial Hardware Removal: A Case Report
- 1Department of Orthopaedic Surgery, The University of Toledo Medical Center, Toledo, OH.
Abstract
Introduction: Periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) remains a devastating complication, particularly in patients with associated periarticular hardware. Traditional two-stage revisions recommend complete hardware removal to ensure full resolution of the infection; however, this decreases mechanical stability, introduces susceptibility to fractures, and larger incisions with soft tissue disruption. Case Repot: We report the case of a 67-year-old male with a chronic PJI following TKA and distal femur fixation. The infected prosthesis and intra-articular plate segment were removed, while the proximal portion of the plate was retained for stability. The infection was eradicated following staged revision and targeted antibiotic therapy. At the 29-month follow-up, the patient remained infection-free and able to bear full weight. Conclusion: This case illustrates that partial hardware retention may be a viable alternative in select patients requiring both infection control and structural preservation.
Related
- Managing periprosthetic joint infection through the direct anterior approach: Partial two-stage exchange with femoral stem retention
- Culture-Specific Outcomes of Intra-Articular Antibiotic Infusion With Implant-Retaining Debridement for Periprosthetic Joint Infection After Unicompartmental Knee Arthroplasty
- From Measured Accuracy to Patient Outcome: Navigation in Total Hip Arthroplasty and Molecular Diagnosis of Periprosthetic Joint Infection: A Narrative Review
- Extensor Mechanism Reconstruction Following Periprosthetic Joint Infection After Total Knee Arthroplasty: A Systematic Review
- Antibiotic-Loaded Hydrogel, Calcium Bead, and Cement in Periprosthetic Joint Infection Following Hip-Knee Arthroplasty: A Systematic Review and Meta-Analysis of Commercially Available Products
BibTeX
@article{boesel2026management,
title = {{Management of Periprosthetic Total Knee Infection with Partial Hardware Removal: A Case Report}},
author = {Joseph Boesel and Ibrahim Ifetiha and Neal Chase Farmer and David Yatsonsky and Maged Hanna},
journal = {Journal of Orthopaedic Case Reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8418},
url = {https://doi.org/10.13107/jocr.2026.v16.i11.8418},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Management of Periprosthetic Total Knee Infection with Partial Hardware Removal: A Case Report
AU - Joseph Boesel
AU - Ibrahim Ifetiha
AU - Neal Chase Farmer
AU - David Yatsonsky
AU - Maged Hanna
PY - 2026
DA - 2026/11/01
JO - Journal of Orthopaedic Case Reports
DO - 10.13107/jocr.2026.v16.i11.8418
UR - https://doi.org/10.13107/jocr.2026.v16.i11.8418
AB - Introduction: Periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) remains a devastating complication, particularly in patients with associated periarticular hardware. Traditional two-stage revisions recommend complete hardware removal to ensure full resolution of the infection; however, this decreases mechanical stability, introduces susceptibility to fractures, and larger incisions with soft tissue disruption. Case Repot: We report the case of a 67-year-old male with a chronic PJI following TKA and distal femur fixation. The infected prosthesis and intra-articular plate segment were removed, while the proximal portion of the plate was retained for stability. The infection was eradicated following staged revision and targeted antibiotic therapy. At the 29-month follow-up, the patient remained infection-free and able to bear full weight. Conclusion: This case illustrates that partial hardware retention may be a viable alternative in select patients requiring both infection control and structural preservation.
SN - 2250-0685
SN - 2321-3817
ER -