[The treatment of periprosthetic infections].
Periprosthetic infections are severe complications following total joint arthroplasty. The infection rate is estimated to be 0.5-2%. Systemic diseases such as rheumatoid arthritis and previous surgery are considered risk factors for infection. The infection rate in the present patient cohort was low (0.72%). The recurrence rate (23.4%) is due to patients with rheumatoid arthritis and septic total knee arthroplasties. Successful treatment is dependent on various factors, one of which involves accurate preoperative bacterial diagnostics. Joint fluid aspiration is the appropriate procedure. Open biopsy or arthroscopically guided biopsy can be performed in cases of unclear diagnostic results. Early infection can be treated with thorough joint debridement without exchanging fixed implant components; "low-grade" or late infections require revision with implant removal in a one or two stage septic revision according to clearly determined algorithms. Antibiotic therapy is mandatory, and a combination with rifampicin is a very useful basis.
Lohmann
C H
CH
Lehrstuhl für Orthopädie, Universitätsklinikum Hamburg-Eppendorf. LohmannCH@t-online.de
Fürst
M
M
Niggemeyer
O
O
Rüther
W
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000601:surgery*; D019643:Arthroplasty, Replacement; D019644:Arthroplasty, Replacement, Hip; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007595:Joint Prosthesis / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation; D012307:Risk Factors
D018836:Inflammation Mediators