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Open Access Research article

Value of digital telethermography for the diagnosis of septic knee prosthesis: a prospective cohort study

Carlo Luca Romanò1*, Roberto D’Anchise2, Marco Calamita1, Giovanni Manzi1, Delia Romanò1 and Valerio Sansone3

Author Affiliations

1 Dipartimento di Chirurgia Ricostruttiva e delle Infezioni Osteo-articolari, Istituto Ortopedico I.R.C.C.S, Galeazzi - Via Riccardo Galeazzi, 4 - Milano, 20166, Italy

2 Dipartimento di Chirurgia del Ginocchio, Istituto Ortopedico I.R.C.C.S, Galeazzi - Via Riccardo Galeazzi, 4 - Milano, 20166, Italy

3 Istituto Ortopedico I.R.C.C.S, Clinica Ortopedica, Galeazzi - Via Riccardo Galeazzi, 4 - Milano, 20166, Italy

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BMC Musculoskeletal Disorders 2013, 14:7  doi:10.1186/1471-2474-14-7

Published: 4 January 2013



Diagnosis of peri-prosthetic infection remains challenging, often requiring a combination of different tests.


In this prospective, case–control study, the diagnostic accuracy of telethermography was evaluated in a group of seventy patients who had had a total knee replacement and were undergoing a reoperation because of infection or another implant-related problem, after a minimum of one year from implant.


An average differential temperature of the affected versus not affected knee of 1.9°C was observed in infected prosthesis, compared to 0.3°C in aseptic failures. Considering a normal reference value equal or less than 1.0°C, telethermography showed an accuracy, sensitivity, specificity, positive and negative predictive value of, respectively: 0.90, 0.89, 0.91, 0.91, 0.88.


Digital telethermography is a reliable option for diagnosing peri-prosthetic knee infection.

Knee; Total knee replacement; TKR; Infection; Thermography; Diagnosis