The Changing Face of Infection, Diagnosis, and Management in the United Kingdom

Orthop Clin North Am. 2020 Apr;51(2):141-146. doi: 10.1016/j.ocl.2019.12.003. Epub 2020 Feb 4.

Abstract

Prosthetic joint infection is still a rare but devastating complication following total hip and knee arthroplasty. The incidence of prosthetic joint infection ranges from 2% to 4% in primary procedures as opposed to nearly 20% in revisions. The challenges that arise here include mainly diagnostic uncertainty, management in immunocompromised patients, recurrent infection, infection around a well-fixed implant, and substantial bone loss, and require careful preoperative assessment and well-defined management plans. This article summarizes recent developments in the diagnosis and management of this increasingly prevalent issue specifically focusing on outcomes following debridement, antibiotics, and implants retention and one-stage revision procedures.

Keywords: Dair; Diagnosis; One stage; Prosthetic joint infection; Two stage.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Biomarkers / analysis
  • Debridement
  • Device Removal
  • Humans
  • Joint Prosthesis / adverse effects
  • Joint Prosthesis / microbiology
  • Prosthesis-Related Infections / diagnosis*
  • Prosthesis-Related Infections / etiology
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / therapy*
  • United Kingdom

Substances

  • Anti-Bacterial Agents
  • Biomarkers