Priority 2 from the Revision Knee Replacement PSP

UNCERTAINTY: What is the best way to diagnose and treat infection of a knee replacement? (JLA PSP Priority 2)
Overall ranking 2
JLA question ID 0093/2
Explanatory note Infection is a devastating complication following knee replacement which is related to significant morbidity and mortality. Patients are affected in their quality of life, and this issue creates a significant health economic burden. Thus the timely, accurate detection of infection, as well as optimising treatment modalities remains a key goal for arthroplasty surgeons.
Evidence

None identified
Health Research Classification System category Musculoskeletal
Extra information provided by this PSP
Original uncertainty examples How do we treat the bone following removal of implants in infected knee replacement ~ Is it possible to eradicate biofilm from an infected knee prosthesis without removing the implant? ~ During my initial consultation my question would be what are the options open to me. (I guess the surgeon will only truly know after he has opened up the knee). Could an infection be treated by non surgical methods. i.e. anti-biotics, Hyperbaric Treatment etc. ~ What are the best tests to diagnose infected knees? ~ What blood tests diagnose infection? ~ It took a long time to diagnose my infection. Why?
Submitted by See data spreadsheet on JLA website
PSP information
PSP unique ID 0093
PSP name Revision Knee Replacement
Total number of uncertainties identified by this PSP. 32 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 21 May 2019