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Background <p>The infected stiff knee joint represents a&#xa0;substantial clinical challenge, as there is yet no universally accepted treatment strategy.</p> Objective <p>This article aims to provide practical recommendations for preventing stiffness in infected knee joints in various categories: prosthetic joint infections (PJI), fracture-related infections (FRI), infections following arthroscopic procedures involving foreign material, and native septic arthritis (SANJO).</p> Material and methods <p>The article analyzes the current literature on infected knee joints, focusing on measures to maintain the range of motion. Published guidelines, clinical studies, expert opinions, and the authors’ own experiences are included.</p> Results <p>An early and accurate diagnosis is crucial to prevent joint stiffness. A&#xa0;clear surgical strategy established before the first operation, along with the early involvement of an interdisciplinary team (including infectious diseases, internal medicine, physiotherapy and, if necessary, plastic surgery), are essential. Early debridement, a&#xa0;tension-free wound closure and adequate pain management promote mobilization. Unnecessarily repeated debridement, the use of open negative pressure wound therapy (NPWT) and drainages should be avoided. Early postoperative mobilization is critical and continuous passive motion (CPM) splints can be supportively used, while immobilization in braces and bed rest without clear indications should be avoided.</p> Conclusion <p>Eradication of the infection remains the primary goal to ensure long-term joint function. Overall, the recommendations described here provide a&#xa0;structured approach to minimize the risk of joint stiffness.</p>

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Das infizierte steife Kniegelenk – Dos and Don′ts

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月18日

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  • Petros Ismailidis,
  • Martin Clauss

摘要

Background

The infected stiff knee joint represents a substantial clinical challenge, as there is yet no universally accepted treatment strategy.

Objective

This article aims to provide practical recommendations for preventing stiffness in infected knee joints in various categories: prosthetic joint infections (PJI), fracture-related infections (FRI), infections following arthroscopic procedures involving foreign material, and native septic arthritis (SANJO).

Material and methods

The article analyzes the current literature on infected knee joints, focusing on measures to maintain the range of motion. Published guidelines, clinical studies, expert opinions, and the authors’ own experiences are included.

Results

An early and accurate diagnosis is crucial to prevent joint stiffness. A clear surgical strategy established before the first operation, along with the early involvement of an interdisciplinary team (including infectious diseases, internal medicine, physiotherapy and, if necessary, plastic surgery), are essential. Early debridement, a tension-free wound closure and adequate pain management promote mobilization. Unnecessarily repeated debridement, the use of open negative pressure wound therapy (NPWT) and drainages should be avoided. Early postoperative mobilization is critical and continuous passive motion (CPM) splints can be supportively used, while immobilization in braces and bed rest without clear indications should be avoided.

Conclusion

Eradication of the infection remains the primary goal to ensure long-term joint function. Overall, the recommendations described here provide a structured approach to minimize the risk of joint stiffness.