Journal of Chemotherapy Vol. 13 - n. 2 (182-187) - 2001 © E.I.F.T. srl - Firenze ISSN 1120-009X INTRODUCTION In joint implantation, deep infection involv- ing the prosthetic device is a serious complica- tion, causing postoperative morbidity and pros- thesis failure 1,2 . Indeed, although occurring in a small proportion of patients, deep infection can be devastating and result in major morbidi- ty, often requiring additional surgery and pro- longed antimicrobial therapy. Two major mech- Postoperative Infections Following Total Knee Replacement: An Epidemiological Study L. LAZZARINI - G. PELLIZZER - C. STECCA - R. VIOLA 1 - F. DE LALLA Department of Infectious Diseases, San Bortolo Hospital, Vicenza and 1 Department of Orthopedics, Ospedale Civile Campo SS. Giovanni e Paolo, Venezia, Italy. Correspondence: Luca Lazzarini, M.D., Divisione Malattie Infettive, Ospedale S. Bortolo, via Rodolfi, 36100 Vicenza, Italy. Tel +390444 993998; Fax +390444 993616; E-mail fdl.vi@gpnet.it Summary From January 1991 to June 1997 217 patients undergoing monolateral or bilateral total knee replacement (TKR) were consecutively enrolled in a prospective study on the incidence of postoperative infections and related risk factors. Regional antimicrobial prophylaxis (teicoplanin 400 mg) was used in 263 (95%) prostheses implanted; in the remaining 14 implants (5%) periopera- tive antibiotic prophylaxis (teicoplanin 800 mg) was administered as usual by systemic route. None of the patients experienced local or systemic adverse effects. Over the 2-year follow-up period, 8 (2.9%) primary site infectious com- plications were recorded, i.e. 4 superficial infections, which were cured without involvement of the prostheses, and 4 deep infections, which required prosthe- sis removal. Six infections occurred in patients who had undergone previous surgery of the same knee joint, and 2 in patients undergoing primary TKR (p= 0.0005); diabetic patients had infections (13%) more frequently than non-dia- betic patients (1.9%, p=0.01). Staphylococci were the leading organisms isolat- ed from infections; however 3 strains of Escherichia coli were isolated from patients who had undergone a previous prosthesis implantation at the same knee joint. Regional administration of teicoplanin appears to be a safe and valuable prophylactic technique; however, in patients at risk of infection a pro- phylactic regimen which is also active against Gram-negative bacteria should probably be considered. Key words: Teicoplanin prophylaxis, prosthetic knee infection, reimplanta- tion, surgical infection. REPRINT REVIEW