An analysis of complex, life-threatening infectious complications of hip and knee joint arthroplasty based on departmental data

Pol Orthop Traumatol. 2013 Dec 16:78:251-7.

Abstract

Background: The growing popularity of arthroplasty results in an increase in the number of infectious complications. The clinical course of inflammation, silent initial symptoms of the disease and non-medical factors, such as poor public awareness and difficulty in finding specialist care, lead patients to postpone the decision about surgical intervention. This results in a state of imminent threat to health or life by endangering other organs of the body. The purpose of this study was to analyze extreme cases of vital organ damage due to infections following hip and knee replacement procedures.

Material and methods: Retrospective analysis of selected cases of life-threatening infectious complications resulting in vital organ damage (urinary tract, large vessels, cardiorespiratory system, etc.) treated at the Department of Orthopedics at the Center of Postgraduate Medical Education (CPME) over the past 12 years.

Results: Establishment of an early diagnosis, and above all, confirmation of periprosthetic infection are extremely important. This allows for a biologically reasonable, early and radical management with the best possible treatment options and prevents the risk of life-threatening complications.

Conclusions: Universal access to antibiotics, suppression rather than treatment of infections, silent and unusual course of septic joint loosening and the lack of sufficient awareness of the problem among physicians, contribute to the reoccurrence of such cases and cause significant treatment challenge. They require management at multidisciplinary centers specializing in such cases and rarely end successfully.

Publication types

  • Case Reports

MeSH terms

  • Abscess / microbiology
  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Cutaneous Fistula / microbiology
  • Enterobacter / isolation & purification
  • Enterobacteriaceae Infections / diagnosis*
  • Enterobacteriaceae Infections / microbiology
  • Equipment Failure Analysis
  • Fatal Outcome
  • Female
  • Femoral Neck Fractures / therapy
  • Humans
  • Knee Prosthesis / adverse effects
  • Male
  • Prosthesis-Related Infections / microbiology*
  • Pseudarthrosis / therapy
  • Reoperation
  • Shock, Septic / microbiology