Late prosthetic joint infections: a problem for family physicians

Infection occurs in 1 to 4 percent of the 185,000 prosthetic joint implantations performed each year. Over half of these infections occur more than 12 weeks after surgery, when the patient has been returned to the care of the family physician. Late prosthetic joint infections are usually hematogenously acquired from other sites. Physical signs and symptoms are nonspecific, and diagnostic imaging, primarily bone and indium scanning, is required to differentiate an infected prosthesis from a loose, noninfected component. Treatment involves antibiotics, debridement and removal of the prosthetic component. Prosthetic joint infections may be prevented by early recognition and treatment of distant infections, early recognition of potential prosthetic joint infections and the use of prophylactic antibiotics in selected patients.