{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T05:12:04Z","timestamp":1773205924303,"version":"3.50.1"},"reference-count":6,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,9,29]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>We report the case of a 77-year-old woman who presented with a 10-day history of increasing swelling and erythema of her right calf and popliteal areas 12 years after bilateral total knee replacements. Deep venous thrombosis (DVT), cellulitis or possible deep sepsis as a result of the knee replacement were the initial differential diagnoses. Due to clinical deterioration, exploration and radical debridement were performed and a 1.5 L collection of pus was identified through a small posteromedial proximal tibial bone defect adjacent to the tibial component, extending between gastrocnemius, soleus and into the distal calf. The procedure was extended to a first stage revision (complete implant and cement removal). Although leg swelling is common in joint infections secondary to knee swelling as a result of the inflammation, synovitis and\/or knee effusion response, this case highlights the need to consider additional pathology such as deep abscess formation or DVT in these types of presentations.<\/jats:p>","DOI":"10.1136\/bcr-2018-227830","type":"journal-article","created":{"date-parts":[[2019,11,21]],"date-time":"2019-11-21T21:25:29Z","timestamp":1574371529000},"page":"e227830","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Beware of the hot swollen calf following knee replacement surgery: it might not be a deep vein thrombosis"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7883-8696","authenticated-orcid":false,"given":"Benedict","family":"Lotz","sequence":"first","affiliation":[{"name":"Orthopedics and Traumatology and Paraplegiology, UniversitatsKlinikum Heidelberg, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antony","family":"Palmer","sequence":"additional","affiliation":[{"name":"Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunny D","family":"Deo","sequence":"additional","affiliation":[{"name":"Trauma and Orthopaedics, Great Western Hospitals NHS Foundation Trust, Swindon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,11,21]]},"reference":[{"key":"2025082712203668000_12.11.e227830.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.09.053"},{"key":"2025082712203668000_12.11.e227830.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra040181"},{"key":"2025082712203668000_12.11.e227830.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2007.01.007"},{"key":"2025082712203668000_12.11.e227830.4","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.b1773","article-title":"Diagnosis and management of prosthetic joint infection","volume":"338","author":"Matthews","year":"2009","journal-title":"BMJ"},{"key":"2025082712203668000_12.11.e227830.5","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq305"},{"key":"2025082712203668000_12.11.e227830.6","doi-asserted-by":"publisher","DOI":"10.1080\/00365540600978963"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-227830","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:20:41Z","timestamp":1756322441000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-227830"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":6,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,11,21]]},"published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1136\/bcr-2018-227830"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-227830","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]}}}