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Periprosthetic infections after total hip and knee arthroplasty--a review
Insights
Periprosthetic joint infections (PJI) are serious complications after total joint arthroplasty. Early diagnosis and multidisciplinary treatment are crucial for managing these challenging orthopedic infections.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Biomedical Engineering
Background:
- Periprosthetic joint infections (PJI) represent a significant and challenging complication following total joint arthroplasty.
- These infections impose a substantial long-term medical, familial, and financial burden.
- The increasing number of joint replacement surgeries correlates with a rise in PJI cases, some life-threatening.
Purpose of the Study:
- To review current advancements in the prevention and treatment of PJI.
- To highlight the importance of early and accurate diagnosis of postoperative PJI.
- To summarize effective management strategies and suggest future research directions.
Main Methods:
- Review of existing literature on PJI diagnosis and treatment.
- Analysis of diagnostic modalities including laboratory tests, imaging, histopathology, and microbiology.
- Evaluation of various treatment options such as antibiotic therapy, revision surgeries, and Girdlestone procedures.
Main Results:
- Advanced diagnostic tools enable accurate and early detection of PJI.
- Treatment success is contingent upon factors like symptom onset, patient condition, and pathogen type.
- A multidisciplinary approach is essential for optimal PJI management.
Conclusions:
- Effective PJI management requires a comprehensive strategy integrating diagnostics and tailored treatments.
- Further research and technological development are vital to improve PJI outcomes.
- Options range from conservative management to surgical interventions including revision arthroplasty and amputation.
Abstract:
Periprosthetic joint infections (PJI) in orthopedic surgery are considered to be very serious and dangerous complications of total joint arthroplasty. PJI becomes a long-lasting medical problem and a heavy burden on patient and his family. Patients with such a complication are a significant financial burden for the health care system. Recognizing this issue, investing in scientific research and simultaneously developing technologies in medicine are efforts taken to increase successfulness in preventing and treating PJI. Each year the number of total joint arthroplasties increases which entails a rise in the number of complications among which infections are the leading ones. Sometimes, in the worst case scenarios, infections can endanger patients' lives. New procedural algorithms and new diagnostic possibilities help us make accurate and early diagnoses of postoperative PJI with a great degree of certainty. These diagnostic methods include laboratory tests, imaging, histopathology and microbiological analyses. Treatment options depend on many factors which include the onset of symptoms, patients'general physical condition and type of pathogen. The approach to treating PJI is complex and it requires a multidisciplinary approach in order to ensure the most successful treatment possible. For adequate and successful treatment we need to take into account antibiotic therapy, one-stage or two-stage revision, Girdlestone operation, athrodesis and amputation. In this review we will try to sum up all relevant findings and suggest further steps in management of PJI.
