Diagnosis and management of prosthetic joint infection

Joint replacement is safe, cost effective,1 and widely undertaken. Most prosthetic joint replacements are hips and knees; more than 130 000 people underwent such procedures in England and Wales in the 12 months from April 2006. Subsequent prosthetic joint infection is uncommon -- the incidence varie...

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Bibliographic Details
Published in:BMJ 2009-05, Vol.338 (7707), p.1378-1383
Main Authors: Matthews, Philippa C, Berendt, Anthony R, McNally, Martin A, Byren, Ivor
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Antibiotics
Arthroplasty
Biofilms
Bones
Clinical Laboratory Techniques
CLINICAL REVIEW
Debridement
Diagnosis
Diagnostic Imaging
Heterogeneity
Hips
Humans
Infection
Infections
Joint diseases
Joint prostheses
Joint Prosthesis - adverse effects
Knee joint
Microbiological Techniques
Microbiology
Morbidity
Prosthesis
Prosthesis-Related Infections - diagnosis
Prosthesis-Related Infections - microbiology
Prosthesis-Related Infections - therapy
Prosthetics
Referral and Consultation
Reoperation
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Description
Summary:Joint replacement is safe, cost effective,1 and widely undertaken. Most prosthetic joint replacements are hips and knees; more than 130 000 people underwent such procedures in England and Wales in the 12 months from April 2006. Subsequent prosthetic joint infection is uncommon -- the incidence varies between 0.6% and 2% per joint per year. However, this complication is associated with substantial morbidity and economic cost ($30 000 (?20 ?500; 22 800) to /BFM2X4B|END50 000 per patient). The diagnosis of prosthetic joint infection is difficult, because symptoms, signs, and investigations may all be non-specific. Defining diagnostic criteria and optimum management is complicated by patient heterogeneity and the small numbers in many published studies. However, prompt recognition and diagnosis of prosthetic joint infection facilitates timely intervention to salvage infected joints, preserve joint function, prevent morbidity, and reduce costs. Adapted from the source document.
ISSN:0959-8138
0959-535X
1468-5833
1756-1833
DOI:10.1136/bmj.b1773