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Periprosthetic joint infection caused by Brucella following total joint arthroplasty
Wei Wang1, Li Wang1, Haiwei Dou1
1Department of Joint Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China.
Background:
Brucellosis is a common zoonotic infection that imposes a substantial economic burden on China, particularly in Xinjiang. This study aims to discuss the treatment of Brucella infection following total joint arthroplasty and evaluate its therapeutic effectiveness.
Methods:
We conducted a retrospective case series analyzing 8 patients who developed periprosthetic joint infection (PJI) due to Brucella after arthroplasty in our department between March 2009 and March 2019. The age range of these patients was 55-79 years, with an average age of 65.6 ± 1 year. Various parameters, including the Harris hip score (HHS), knee range of motion (ROM), visual analog scale (VAS) score for pain assessment, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) level, were assessed before and after the revision surgery. Postoperative x-rays were used to assess the curative effect of revision surgery.
Results:
All patients experienced pain and elevated ESR levels. However, none of these patients exhibited deep vein thrombosis (DVT) or nerve damage. Additionally, no skin sinuses were detected. All infected patients underwent revision surgery subsequent to initial total joint arthroplasty. The follow-up period ranged from 6 to 30 months, with an average duration of 14 ± 0.5 months. After revision surgery, both HHS and Harris score assessments, as well as x-rays, were conducted to evaluate the curative effect. No cases of aseptic loosening or prosthesis fracture occurred during or after the revision operation, and no recurrence of infection were observed. The average knee ROM improved to 90 ± 3°.
Conclusions:
Recent clinical findings indicate that systemic antibiotic chemotherapy combined with surgical techniques is effective in treating patients following total joint arthroplasty. Revision surgery significantly improves joint function and alleviates pain.
Insights
Brucellosis infection after joint replacement is treatable. Revision surgery combined with antibiotics effectively resolves Brucella periprosthetic joint infection, improving patient outcomes and joint function.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Public Health
Background:
- Brucellosis is a significant zoonotic infection in China, particularly Xinjiang.
- It poses a considerable economic burden.
- This study focuses on Brucella infection post-total joint arthroplasty.
Purpose of the Study:
- To discuss the treatment of Brucella infection following total joint arthroplasty.
- To evaluate the therapeutic effectiveness of interventions for Brucella periprosthetic joint infection (PJI).
Main Methods:
- Retrospective case series of 8 patients with Brucella PJI after arthroplasty (2009-2019).
- Assessed clinical parameters: Harris hip score (HHS), knee range of motion (ROM), visual analog scale (VAS), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP).
- Evaluated outcomes using postoperative X-rays and clinical assessments post-revision surgery.
Main Results:
- All patients presented with pain and elevated ESR; no deep vein thrombosis or nerve damage observed.
- Revision surgery was performed on all patients, with a follow-up of 6-30 months.
- Significant improvements noted in HHS, knee ROM (average 90°), and pain reduction; no infection recurrence or complications like aseptic loosening.
Conclusions:
- Systemic antibiotic chemotherapy and surgical techniques are effective for Brucella PJI.
- Revision surgery significantly enhances joint function and alleviates pain in patients with Brucella infection post-arthroplasty.
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