A Case of Total Knee Replacement Infected with Clostridium perfringens

India
Mumbai

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A 74-year-old man presented with a complaint of right knee pain for the past 6 months. He reported that the pain had worsened over several years, resulting in limitation of his activities of daily living and walking distance. He denied a history of rheumatoid arthritis. Degenerative changes were visible in radiographs in all three compartments of his right knee, with a 15° intra-articular valgus deformity. A diagnosis of osteoarthritis was made. The decision was made to perform a cemented total knee replacement (TKR). The pre-operative workup revealed a normal chest radiograph, with normal laboratory values. Urine microscopy and culture were clear. Rheumatologic screen was normal. A cemented TKR was performed. The macroscopic features of hyper-trophic or caseating necrosis were not seen in synovium. Three weeks post surgery he developed painful erythema and tenderness over the incision site, which was associated with low-grade fever and chills. His condition deteriorated and he developed an abscess over the incision site.

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