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Abstract:
We define infection as a bacterial inflammation that prolongs the treatment period or impairs the end result. Without a proper definition of terms, statistics are not comparable. A strict differentiation of "septic" and "aseptic" is not possible. The count of contaminated air particles has a relatively low influence on the incidence of infections. Joint puncture with joint irrigation is not only an indispensable procedure in diagnosis; together with systemic antibiotics it can also combat an infection, provided that the prosthesis is still stable. Joint irrigation preceding one-stage revision improves the prognosis and should therefore always be considered. Between 1980 and 1988, out of 42 deep infections 11 were successfully treated by irrigation alone. In 26 cases healing was accomplished by one-stage revision, and there were 5 treatment failures, in only 2 of which Girdlestone resections were involved.
Insights
Defining deep joint infections is crucial for comparable statistics. Joint irrigation, with or without systemic antibiotics, can effectively treat infections, especially when preceding a one-stage revision.
Area of Science:
- Orthopedic surgery
- Infectious disease management
- Prosthetic joint infections
Context:
- Accurate definitions are essential for comparing infection statistics in orthopedic procedures.
- The influence of airborne particle contamination on infection rates is minimal.
- Distinguishing between septic and aseptic conditions can be challenging.
Purpose:
- To define deep joint infection and evaluate treatment outcomes.
- To highlight the role of joint irrigation and systemic antibiotics in managing prosthetic joint infections.
- To assess the efficacy of one-stage revision preceded by joint irrigation.
Summary:
- Deep joint infection is defined as bacterial inflammation prolonging treatment or impairing outcomes.
- Joint puncture and irrigation, combined with systemic antibiotics, can successfully treat infections in stable prostheses.
- One-stage revision preceded by joint irrigation demonstrated improved prognosis, with 26 out of 42 deep infections successfully treated.
Impact:
- Establishes clear definitions for infection in orthopedic surgery, enabling more reliable data comparison.
- Demonstrates the effectiveness of joint irrigation as a therapeutic and diagnostic tool.
- Supports the consideration of joint irrigation before one-stage revision for better patient outcomes in prosthetic joint infections.