Brucella infection following total joint arthroplasty: A systematic review of the literature

Acta Orthop Traumatol Turc. 2018 Mar;52(2):148-153. doi: 10.1016/j.aott.2017.11.003. Epub 2017 Dec 7.

Abstract

Introduction: The aim of this systematic review was to analyze the results of published treatment options in Brucella infection following total joint arthroplasty (TJA).

Methods: We performed a systematic review of the literature regarding outcomes of Brucella infection after TJA (hip and knee). We searched multiple databases for articles in the area published from 1950 to 2016.

Results: A total of 18 patients (12 male and 6 female; mean age 59 years) from 14 published studies were identified. The minimum follow-up time was 6 months (range, 6-120 months). Seven patients were treated with debridement or antibrucella treatment only. Eleven patients (61%) underwent removal of the prosthesis and were treated with one or two-stage exchange arthroplasty. The mean duration of antibiotic therapy was 5.8 months. There was no relapse of infection.

Conclusions: In the absence of loosening of the components of the prosthesis, an attempt to treat Brucella infection medically might be a reasonable choice. One or two-stage exchange arthroplasty could provide successful results without relapse of infection when combined with appropriate antibiotherapy.

Level of evidence: Level III, therapeutic study.

Keywords: Arthroplasty; Brucella; Periprosthetic infection; Treatment.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Clinical Decision-Making
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prosthesis-Related Infections* / drug therapy
  • Prosthesis-Related Infections* / surgery
  • Reoperation / methods*

Substances

  • Anti-Bacterial Agents