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Factors affecting implant retention in infected joint replacements
Jean-Claude Theis1, Shanu Gambhir, Jonathan White
1Department of Orthopaedic Surgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. jean-claude.theis@stonebow.otago.ac.nz
ANZ Journal of Surgery
|September 7, 2007
Summary
Treating infected joint replacements is challenging, with outcomes varying significantly. Patients have a roughly 30% chance of retaining their prosthesis, successful revision, or having no implants post-treatment.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Biomedical Engineering
Background:
- No standardized treatment exists for infected joint replacements.
- Current treatment options present challenges in efficacy and cost-effectiveness.
- Infected joint replacements require careful management due to varied outcomes.
Purpose of the Study:
- To analyze treatment outcomes for infected joint replacements.
- To evaluate prosthesis retention rates and bacteriology.
- To inform clinical decision-making for infected joint replacements.
Main Methods:
- Retrospective review of 73 infected joint replacement cases (1990-2000).
- Analysis of primary treatment, final outcomes, and prosthesis retention.
- Microbiological analysis of causative agents.
Main Results:
- 69% received surgical debridement and IV antibiotics; 34% lost implants.
- Prosthesis retention higher in acute (85-100%) vs. late (20-50%) infections.
- Staphylococcus and Streptococcus were the primary pathogens (76%).
Conclusions:
- Patients with infected joint replacements have a ~30% chance of prosthesis retention, successful revision, or implant removal.
- Treatment success is influenced by infection timing (acute vs. late).
- Understanding causative bacteria aids in managing infected joint replacements.
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