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Arthrotomy, debridement, and polyethylene exchange
16%
61/384
One-stage exchange arthroplasty
3%
11/384
Two-stage exchange arthroplasty
18%
70/384
Parenteral antibiotics
12/384
Nonsurgical management without antibiotics
60%
230/384
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Synovial fluid analysis is a very sensitive tool for detecting infection in total knee arthroplasties. Several studies have demonstrated that an absolute leukocyte count in the synovial fluid of less than 1,700 to 2,500/mm3 is an accurate predictor of absence of infection. Similarly, a differential cell count of the WBCs demonstrating less than 50% to 60% neutrophils is an accurate predictor of absence of infection. If both parameters are normal, it is unlikely that the patient has an infection. The three surgical options are contraindicated based on the normal examination findings and laboratory parameters. Similarly, antibiotics should be avoided. The work-up should include tests to evaluate noninfectious sources of knee pain and sources of referred knee pain.
1.5
(25)
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