Biofilm related total knee arthroplasty infection: prevention, diagnosis and treatment

Document Type : In Brief


Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain



Biofilm related implant infection is undoubtedly a relevant challenge in total knee arthroplasty (TKA) with our comprehension steadily progressing and novel management approaches being developed. The aim of this article was to review the most important advances in approaches to combat infections due to biofilm-forming bacteria in TKA. The main conclusions were the following: 1) Fundamental management techniques for infected TKA include DAIR (debridement, antibiotics, and implant retention), and one and two-stage revision TKA; 2) Continuous local antibiotic perfusion (CLAP) appears to diminish the risk of PJI; 3) Restraint of quorum sensing seems to avert PJI after TKA; 4) A recent in vitro study showed promising results in the prevention and management of PJI after TKA using PMMA [poly(methyl methacrylate)] loaded with up to 100 mg of rifampin.

Level of evidence: III


Main Subjects

Articles in Press, Accepted Manuscript
Available Online from 05 May 2024
  • Receive Date: 17 January 2024
  • Revise Date: 15 April 2024
  • Accept Date: 27 April 2024