Acute Hematogenous Infection Following Total Hip and Knee Arthroplasty

Abstract Forty consecutive patients (42 joints; 22 TKA, 20 THA) treated for acute hematogenous infections were reviewed. All patients underwent irrigation and debridement and exchange of the modular components. At a mean of 56 months (range, 25–124 months) recurrent infection, requiring surgery, dev...

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Bibliographic Details
Published in:The Journal of arthroplasty 2014-03, Vol.29 (3), p.469-472
Main Authors: Konigsberg, Beau S., MD, Valle, Craig J. Della, MD, Ting, Nicholas T., MD, Qiu, Fang, PhD, Sporer, Scott M., MD
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Knee - adverse effects
Bacteremia - etiology
Bacteremia - microbiology
complication
Debridement
Device Removal
Female
hip arthroplasty
Humans
infection
Joint Diseases - surgery
knee arthroplasty
Male
Middle Aged
Orthopedics
Prosthesis-Related Infections - etiology
Prosthesis-Related Infections - microbiology
Prosthesis-Related Infections - therapy
Retrospective Studies
Therapeutic Irrigation
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Summary:Abstract Forty consecutive patients (42 joints; 22 TKA, 20 THA) treated for acute hematogenous infections were reviewed. All patients underwent irrigation and debridement and exchange of the modular components. At a mean of 56 months (range, 25–124 months) recurrent infection, requiring surgery, developed in 9 of the 42 joints (21%); 8 of the 9 recurrent infections were in patients with a staphylococcal infection ( P = 0.0004). Ten of the 40 patients (25%) died within 2 years of infection. Irrigation and debridement for the treatment of an acute hematogenous infection was successful in the majority of patients (76% survivorship at 2 years). Non-staphylococcal infections had a particularly low failure rate (96% survivorship at 2 years). The 2 year mortality rate among this subset of patients was strikingly high.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2013.07.021