Daily Low-Dose Intra-Articular Povidone-Iodine Salvage of Refractory Fungal Total Knee Arthroplasty Infection: A Case Report.

CASE: A 74-year-old woman developed refractory Candida parapsilosis periprosthetic joint infection (PJI) after total knee arthroplasty. Despite repeated debridement, implant removal, antifungal-loaded cement spacers, and prolonged systemic antifungal therapy, infection recurred and amputation was considered. Daily intra-articular low-dose povidone-iodine instillation achieved infection control without adverse events. After a 1-month drug holiday, hinged revision arthroplasty was performed. At 2 years, she ambulated independently without recurrence.

CONCLUSION

Repeated low-dose povidone-iodine instillation may be a salvage option for refractory fungal PJI.