Prosthetic Joint Infections: Bane of Orthopedists, Challenge for Infectious Disease Specialists

Lentino, Joseph R.
May 2003
Clinical Infectious Diseases;5/1/2003, Vol. 36 Issue 9, p1157
Academic Journal
Prosthetic joint infections (PJIs) occur in ∼ 1.5% of all primary hip or knee arthroplasties. The mortality rate attributed to PJIs may be as high as 2.5 Substantial morbidity is associated with a loss of mobility, although this is temporary. The costs associated with a single episode of PJI are ∼ $50,000 per episode, exclusive of lost wages. Risk factors that increase the occurrence of PJI include revision arthroplasty, time in the operating room, postoperative surgical site infection, and malignancy. Pain is the most consistent symptom. Staphylococcus species are the most common organisms isolated from PJI sites. Two-stage revision is superior to single-stage revision or to debridement with prosthesis retention. Long-term antibiotic suppression and/or arthrodesis are useful for patients too frail to undergo extensive surgery. Using an optimal approach, recurrent infection occurs in < 104570360f previously infected joints.


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