title: An analysis of complex, life-threatening infectious complications of hip and knee joint arthroplasty based on departmental data.
abstract: BACKGROUND
  The growing popularity of arthroplasty results in an increase in the number of infectious complications. The clinical course of inflammation, silent initial symptoms of the disease and non-medical factors, such as poor public awareness and difficulty in finding specialist care, lead patients to postpone the decision about surgical intervention. This results in a state of imminent threat to health or life by endangering other organs of the body. The purpose of this study was to analyze extreme cases of vital organ damage due to infections following hip and knee replacement procedures.
  
  
  METHODS
  Retrospective analysis of selected cases of life-threatening infectious complications resulting in vital organ damage (urinary tract, large vessels, cardiorespiratory system, etc.) treated at the Department of Orthopedics at the Center of Postgraduate Medical Education (CPME) over the past 12 years.
  
  
  RESULTS
  Establishment of an early diagnosis, and above all, confirmation of periprosthetic infection are extremely important. This allows for a biologically reasonable, early and radical management with the best possible treatment options and prevents the risk of life-threatening complications.
  
  
  CONCLUSIONS
  Universal access to antibiotics, suppression rather than treatment of infections, silent and unusual course of septic joint loosening and the lack of sufficient awareness of the problem among physicians, contribute to the reoccurrence of such cases and cause significant treatment challenge. They require management at multidisciplinary centers specializing in such cases and rarely end successfully.
authors.affiliation: Department of Orthopedics at the Center of Postgraduate Medical Education (CPME), Independent Public Clinical Hospital, Arthroplasty Division in Otwock, Otwock, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Obrębski
authors.affiliation: Department of Orthopedics at the Center of Postgraduate Medical Education (CPME), Independent Public Clinical Hospital, Arthroplasty Division in Otwock, Otwock, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Kiciński
authors.affiliation: Department of Orthopedics at the Center of Postgraduate Medical Education (CPME), Independent Public Clinical Hospital, Arthroplasty Division in Otwock, Otwock, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Białecki
authors.affiliation: Department of Orthopedics at the Center of Postgraduate Medical Education (CPME), , Independent Public Clinical Hospital, Arthroplasty Division in Otwock, Otwock, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Marczyński
authors.affiliation: Department of Orthopedics at the Center of Postgraduate Medical Education (CPME), , Independent Public Clinical Hospital, Arthroplasty Division in Otwock, Otwock, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Walczak
mesh_terms: D000038:Abscess / Q000382:microbiology; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D017577:Cutaneous Fistula / Q000382:microbiology; D004754:Enterobacter / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000175:diagnosis* / Q000382:microbiology; D019544:Equipment Failure Analysis; D017809:Fatal Outcome; D005260:Female; D005265:Femoral Neck Fractures / Q000628:therapy; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects; D008297:Male; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D011542:Pseudarthrosis / Q000628:therapy; D012086:Reoperation; D012772:Shock, Septic / Q000382:microbiology