Related Experiment Videos
Infection in total joint replacement
1University of Newcastle, New South Wales, Australia.
Abstract:
Although a small number of infections in total joint replacements are blood borne from distant sources, most infections appear to have been derived at operation. Strenuous attempts to reduce this risk by cleaning the air in the wound environment, coupled with prophylactic antibiotics, have reduced infection rates by an order of magnitude in a decade. During that time the potential for exchange arthroplasty in established infection has been shown, and the results are encouraging. Rigorous infection control is the key to containing this difficult and expensive problem.
Insights
Most total joint replacement infections originate during surgery. Improved operating room air quality and prophylactic antibiotics have significantly lowered infection rates, with exchange arthroplasty showing promise for established cases. Rigorous infection control remains crucial.
Area of Science:
- Orthopedic surgery
- Infectious disease control
Background:
- Total joint replacement infections are a significant complication.
- Most infections are acquired intraoperatively, not hematogenously.
- Historically, infection control measures have faced challenges.
Purpose of the Study:
- To review the sources and control of infections in total joint replacements.
- To evaluate the impact of recent infection control advancements.
- To assess the efficacy of exchange arthroplasty for treating established infections.
Main Methods:
- Review of infection sources in total joint replacement surgery.
- Analysis of the impact of environmental controls (e.g., wound air cleaning) and prophylactic antibiotics on infection rates.
- Evaluation of outcomes for exchange arthroplasty in patients with established joint replacement infections.
Main Results:
- Intraoperative acquisition is the primary source of total joint replacement infections.
- Combined air cleaning and prophylactic antibiotics reduced infection rates significantly (by an order of magnitude).
- Exchange arthroplasty demonstrates encouraging results for managing established infections.
Conclusions:
- Meticulous infection control during surgery is paramount for preventing total joint replacement infections.
- Advances in operating room protocols and antibiotic prophylaxis have dramatically improved safety.
- Exchange arthroplasty offers a viable treatment option for persistent joint infections, though prevention is key.