Visual Case Report of a Prosthetic Joint Infection and Chronic Dehiscence following a Total Knee Arthroplasty

This case report highlights a unique presentation of a prosthetic joint infection. A 63-year-old female presented to the emergency department for right knee pain after falling three months earlier, shortly after a total knee arthroplasty. On exam, she was found to have a chronically dehisced wound with exposure of her femur, prosthetic, and overlying cellulitis. She was started on intravenous antibiotics and admitted to the orthopedic surgery service for an above-the-knee amputation. Her unusually delayed presentation and repeated refusal of operative management were heavily influenced by social determinants of health, including polysubstance use, lack of caregiver support, and housing instability.” This uncommon presentation of chronic dehiscence and prosthetic joint infection provides an opportunity to review the management of prosthetic joint infections compared to native joint septic arthritis, how socioeconomic factors drive patient outcomes, and a discussion on medical capacity.