title: Acute hematogenous infection following total hip and knee arthroplasty.
abstract: Forty consecutive patients (42 joints; 22 TKA, 20 THA) treated for acute hematogenous infections were reviewed. All patients underwent irrigation and debridement and exchange of the modular components. At a mean of 56 months (range, 25-124 months) recurrent infection, requiring surgery, developed in 9 of the 42 joints (21%); 8 of the 9 recurrent infections were in patients with a staphylococcal infection (P = 0.0004). Ten of the 40 patients (25%) died within 2 years of infection. Irrigation and debridement for the treatment of an acute hematogenous infection was successful in the majority of patients (76% survivorship at 2 years). Non-staphylococcal infections had a particularly low failure rate (96% survivorship at 2 years). The 2 year mortality rate among this subset of patients was strikingly high.
authors.affiliation: Department of Orthopaedic Surgery, 981080 Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Beau S
authors.initials: BS
authors.lastname: Konigsberg
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Della Valle
authors.affiliation: Cleveland Clinic, Cleveland, Ohio.
authors.forename: Nicholas T
authors.initials: NT
authors.lastname: Ting
authors.affiliation: College of Public Health, 984375 Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Fang
authors.initials: F
authors.lastname: Qiu
authors.affiliation: Winfield, Illinois.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Sporer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D016470:Bacteremia / Q000209:etiology / Q000382:microbiology*; D003646:Debridement; D020878:Device Removal; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000382:microbiology* / Q000628:therapy; D012189:Retrospective Studies; D007507:Therapeutic Irrigation
keywords: complication; hip arthroplasty; infection; knee arthroplasty