title: Results of periprosthetic hip and knee infections caused by resistant bacteria.
abstract: Seventy patients with deep periprosthetic hip or knee infections were treated between May 1997 and March 2001. Thirty-five patients had periprosthetic infections of their total hip arthroplasties and 35 patients had periprosthetic infections of their total knee arthroplasties. The patients were subdivided into two subgroups: patients who had infections with Staphylococcal bacterial strains that were sensitive to methicillin and patients who had infections with bacteria that were resistant to methicillin (methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis). Treatment was considered successful if the patient was able to retain his or her hip or knee prosthesis either as a result of irrigation and debridement procedures alone or after excision of the infected total hip or knee prosthesis followed by successful reimplantation. Treatment was considered a failure if the patient eventually required arthrodesis, amputation, or was left with a permanent excision arthroplasty. Hip replacements that were infected with antibiotic-sensitive bacteria were treated successfully in 81% of cases. In contrast, hip replacements infected with resistant organisms were treated successfully in only 48% of cases. Similarly, knee replacements infected with sensitive organisms had a success rate of 89%, compared with only 18% of the total knee replacements that were infected with resistant bacterial strains.
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest University, School of Medicine, Winston-Salem, NC 27157, USA. dkilgus@wfubmc.edu
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Kilgus
authors.forename: David J
authors.initials: DJ
authors.lastname: Howe
authors.forename: Andrew
authors.initials: A
authors.lastname: Strang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003646:Debridement; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000382:microbiology* / Q000628:therapy; D012086:Reoperation; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology* / Q000628:therapy*; D013211:Staphylococcus aureus / Q000187:drug effects; D013212:Staphylococcus epidermidis / Q000187:drug effects; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents