The incidence of deep prosthetic infections in a specialist orthopaedic hospital

Abstract

The Control of Infection Committee at a specialist orthopaedic hospital prospectively collected data on all episodes of bacteriologically-proven deep infection arising after primary hip and knee replacements over a 15-year period from 1987 to 2001. There were 10 735 patients who underwent primary hip or knee replacement. In 34 of 5947 hip replacements (0.57%) and 41 of 4788 knee replacements (0.86%) a deep infection developed. The most common infecting micro-organism was coagulase-negative staphylococcus, followed by Staphylococcus aureus, enterococci and streptococci. Of the infecting organisms, 72% were sensitive to routine prophylactic antimicrobial agents. Of the infections, 29% (22) arose in the first three months following surgery, 35% between three months and one year (26), and 36% (27) after one year. Most cases were detected early and treated aggressively, with eradication of the infection in 96% (72). There was no significant change in the infection rate or type of infecting micro-organism over the course of this study. These results set a benchmark, and importantly emphasise that only 64% of peri-prosthetic infections arise within one year of surgery. These results also illustrate the advantages of conducting joint replacement surgery in the isolation of a specialist hospital.

High Infection Control Rate and Function After Routine One-stage Exchange for Chronically Infected TKA

“…With modern prophylactic measures, a low incidence of 1% to 2% is to be expected [19]. However, with the increasing number of TKAs performed, the number of infected TKAs will increase in proportion [17].…”

Sonication cultures of explanted components as an add‐on test to routinely conducted microbiological diagnostics improve pathogen detection

“…2 Although much effort has already been expended on reducing the incidence of prosthetic infections, 1,3,4 the incidence of joint infection after primary joint arthroplasty is about 1% for hip and shoulder prostheses, about 2% for knee prostheses, and up to 9% in elbow prostheses. 5,6 Additionally, these infections are associated with considerable costs. 7 Treatment of an infected prosthetic joint on average exceeds the conservative estimate of $50,000 per episode.…”

Articulating Spacers Used in Two-stage Revision of Infected Hip and Knee Prostheses Abrade with Time

“…Periprosthetic infections occur in less than 1% of patients but nevertheless are a serious complication of hip and knee arthroplasties [12,15,26,36,37]. When infections occur within 4 weeks of implantation, the implant can be left in place with a high probability of implant survival of between 80% and 100%, whereas late infections generally require prosthesis revision to control the infection [7,22,44,45].…”