Outcomes of Surgical Treatment of Infectious Complications after Large Joints Arthroplasty

Abstract

Surgical outcomes were analyzed for 108 patients with infectious complications developed at different terms after large joints arthroplasty. When complications develop in the early postoperative period than independently of the process depth and in stable implant components radical surgical debridement of the inflammation focus is indicated. In the rest of cases the removal of all implant components with subsequent either joint arthrodesis or revision arthroplasty using spacers of different modifications should be performed. We consider spacer application to be a method of choice as it enables to preserve extremity function and to perform revision arthroplasty in future.

Etiological role of opportunistic microflora in the pathogenesis of implant-associated inflammation after primary total knee replacement

“…Implant-associated inflammation remains one of the main causes of unsatisfactory outcomes in primary knee arthroplasty [1], which is associated with pathogenetic peculiarities of this typical process, characterized by formation of a microbial biofilm protecting infectious agents due to the polysaccharide complex formation from the effects of nonspecific and specific immunity, as well as from antibacterial pharmaceutical drugs [1,2]. Differential diagnosis between infectious complications and aseptic loosening is often problematic due to several factors: the difficulties in microbiological verification of the pathological process, the need for bacterial examination of aspirate or intraoperative samples from periprosthetic tissues, and slow growth of the causative agents of implant-associated inflammation [3].…”