It looks like I might have an infected knee — and darn it if it isn’t the one that has a joint replacement in it. I have an appointment with the orthopedic surgeon tomorrow. What should I expect?

A knee replacement has become so common any more we tend to forget that it is still major surgery and a fairly complex one at that. With so many aging adults in America, the number of total knee replacements has increased dramatically.

And along with that has come the need to watch out for complications like implant/joint infection. Infection is one of the most common causes of implant failure. Whether infection develops right away (first four to six weeks) after the surgery or much later (even years later), the treatment approach is the same.

First, tests are done to identify what type of organism is growing. The most appropriate antibiotic to combat the infection is selected. If that doesn’t work, then surgery is done to clean out the infection (a procedure called debridement) and possibly replacement of the liner that’s part of the implant.

After debridement, intravenous antibiotics are given for six weeks but patients are warned that the success rate is fairly low. A revision (second) surgery may be required. The implant is removed and replaced but the new implant isn’t put in until the infection is cleared up completely. A temporary spacer is put in the joint instead and the operation becomes a two-part or staged procedure.

But before we jump that far ahead, you are on the right track to see your surgeon and find out what’s going on. Each patient has his or her own unique presentation, problems, and solutions. Having a little idea of the possibilities is good, but wait and see what your physician has to say.