Management of infected knee and hip prostheses

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management

Background:

• The incidence of total hip and knee replacements is increasing globally.
• Consequently, there is a rise in managing infected joint replacements, necessitating effective treatment strategies.
• Infection treatment is costly, emphasizing the importance of prevention and efficient management.

Purpose of the Study:

• To review the diagnosis and treatment of infected knee and hip replacements.
• To provide an overview of current management options for infected joint prostheses.
• To highlight the significance of preventive measures in reducing infection rates.

Main Methods:

• Review of diagnostic and therapeutic procedures for infected total hip and knee replacements.
• Discussion of surgical interventions including debridement, resection arthroplasty, arthrodesis, and amputation.
• Consideration of non-surgical management like antibiotic suppression therapy.

Main Results:

• Preventive measures like preoperative antibiotics and double-gloves can reduce infection risk.
• For infected hip replacements, debridement with prosthesis retention and two-stage reimplantation show good success rates.
• Treatment options for infected knee replacements vary, including debridement, resection arthroplasty, arthrodesis, and amputation, chosen based on patient factors and implant type.

Conclusions:

• Effective management of infected joint replacements requires tailored treatment strategies based on diagnosis, patient condition, and specific prosthesis.
• Two-stage reimplantation is generally more successful for infected hip prostheses than one-stage procedures.
• Arthrodesis and amputation are reserved for complex cases or treatment failures, with arthrodesis potentially leading to limb length discrepancy.