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Periprosthetic Infection in Joint Replacement.

Christina Otto-Lambertz1, Ayla Yagdiran, Franziska Wallscheid

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Artificial joint infections are a significant complication of rising joint replacement surgeries. Prompt diagnosis via joint biopsy and tailored treatment, including surgery and antibiotics, are key to successful outcomes and prosthesis preservation.

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Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Biomedical Engineering

Background:

  • Joint replacement surgeries are increasing due to an aging population seeking to maintain function.
  • Infection is a common complication, occurring in 0.2-9% of cases, with high morbidity and mortality.
  • Optimizing diagnosis and treatment strategies for joint replacement infections is crucial.

Purpose of the Study:

  • To review current diagnostic and therapeutic strategies for artificial joint infections.
  • To highlight the importance of timely and accurate diagnosis and treatment.
  • To identify gaps in evidence and areas for future research.

Main Methods:

  • Selective literature search in PubMed.
  • Inclusion of current guidelines and expert recommendations.
  • Review of pertinent publications on joint replacement infections.

Main Results:

  • Joint biopsy offers over 90% sensitivity and specificity for pathogen identification.
  • Prosthesis salvage is possible in 35-90% of cases with early, aggressive treatment (débridement, antibiotics).
  • Prosthesis revision is often necessary for loose implants or difficult-to-treat pathogens, combined with tailored antibiotic therapy.

Conclusions:

  • Artificial joint infections are a growing concern with increasing implant numbers.
  • Standardized treatment algorithms based on guidelines are recommended.
  • High-quality evidence is lacking for many recommendations, necessitating urgent randomized trials.