Septic Loosening Due to Brucella Melitensis After Bilateral Knee Prosthesis and Two-Stage Total Knee Prosthesis Revision

Infection after total knee replacement is a serious complication associated with a high incidence of morbidity. A prosthetic infection due to Brucella melitensis is a very rare condition. In this study, we describe a case of brucellosis infection with septic loosening of both knee joints after bilaterally cemented total knee prosthesis application; this is rarely encountered in the literature. The patient diagnosis was established by clinical findings (fever, joint swelling, etc.) and supported by laboratory findings and analysis of joint fluid obtained from joint aspiration. Plain radiography and bone scintigraphy confirmed septic loosening. In this case, we performed total knee prosthesis revision bilaterally after antibiotic treatment. We preferred two-stage surgery for the revision. In the first stage, the infected prosthesis was removed and a Teicoplanin-loaded bone cement spacer was inserted in both knees. Twenty weeks later, the second stage was performed. During the 24-month follow-up period, no complications were seen.