JRPMS Vol 6, No 2, June 2022, p.31-36
Current treatment of infected arthroplasties
Elisavet Mantzila, Efstathios Chronopoulos
- Laboratory for the Research of Musculoskeletal System, KAT Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
Keywords: Arthroplasties, Infection, Joint, Prosthetic, Treatment
Total hip and knee arthroplasties are among the most popular and common orthopaedic surgical interventions. Despite the very high success rate of those operations and the ongoing technical improvements, they still carry the risk of various complications, with the deep infections being among the most serious ones. The periprosthetic joint infection is defined as the presence of bacteria in the joint space of the artificial joint and the surrounding tissues, which is significantly associated with laboratory and histological findings and clinical signs of inflammation. Those infections, according to the time of their occurrence are characterized as acute -early postoperative, delayed and chronic. The most common microorganisms responsible for their cause are the coagulase-negative Staphyloccocal species and Staphylococcus aureus. Treatment of those infections involves a variety of combinations of procedures, both conservative and operative; the best treatment is the one which combines the elimination of the infection with the least possible complications for the patient. Debridement with retention of the prosthesis, one stage arthroplasty exchange and two stage arthoplasty exchange are the most commonly accepted surgical procedures for the treatment of this complication, whereas arthroplasty resection without reimplantation and arthrodesis are salvage procedures in order to avoid the unfortunate, but at least very rare solution of the amputation of the limb.