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Published in N°276 - August/September 2018
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Infection and TKA: Medico-legal considerations, good record keeping and best practice

By Florent Weppe (1), Marine Dutertre (2) in category COMPLICATIONS
1 - Lyon Ortho clinic, 29B Avenue des sources, 69009 Lyon / 2 - Clinique de la sauvegarde, 480 Avenue Ben Gourion, 69009 Lyon

Orthopaedic surgery, especially arthroplasty of the knee, is a type of functional surgery. The aim is to improve the patient’s condition and, ultimately, his or her quality of life. Complications are never welcomed by the patient, or by the surgeon, even though both parties are well aware of the risks from the very first consultation.

Orthopaedic surgery, especially arthroplasty of the knee, is a type of functional surgery.  The aim is to improve the patient’s condition and, ultimately, his or her quality of life. Complications are never welcomed by the patient, or by the surgeon, even though both parties are well aware of the risks from the very first consultation. Infections are a dreaded complication of joint replacement surgery, with an incidence of 2000–2500 cases a year and 0.34%(1)–0.6%(2) for knee arthroplasties in France, a figure which rises to 1–2% in Britain.(3)(4) It is the number one complication featuring in medical litigation, mainly due to the financial impact.(5) Such lawsuits are common in orthopaedic surgery (one brought every 18 months), although the figure has remained stable since 2012.(6)  Most of the infections in these lawsuits are multifactorial, and there has been significant media coverage of so-called “hospital-acquired” infections, the considerable impact on treatment and the final functional outcome, and the French law of 4 March 2002 known as the Kouchner Law and its amendments with regard to liability and legal procedure.(7)

The orthopaedic surgeon can best prepare, technically and personally, for the possibility of an infection in a total knee arthroplasty (TKA), by...

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