Delayed onset tuberculosis infection appeared in a total knee implant in a 61-year-old former coal miner. After a five-day interval the knee was salvaged by removal, aggressive debridement, suction-irrigation, and reinsertion. Antituberculosis drugs were administered immediately following surgery on the basis of the characteristic exudate and stat histologic sections showing granulomata formation. At one year follow-up examination the result was excellent. Retention of the total knee implant is a viable alternative to arthrodesis or fibrous ankylosis of the knee in such a case. Tuberculosis should be included in the differential diagnosis in patients with knee joint degenerative disease.
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GARY L. WOLFGANG (1985) studied this question.