title: Decreased infection rates following total joint arthroplasty in a large county run teaching hospital: a single surgeon's experience and possible solution.
abstract: Total joint arthroplasty is a common orthopaedic procedure producing valuable improvements in patient's quality of life. A dreaded complication of this procedure is deep seated, periprosthetic infection. This complication can lead to multiple reoperations and upwards of $100,000 of increased cost burden. At one 900 bed county run teaching hospital, with a historically high infection rate in total joints, the total joint service was closed and restarted using a new protocol, dropping infection rates from 12.9% to 1.9% (P = 0.007).
authors.affiliation: Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Gottschalk
authors.affiliation: Department of Orthopaedic Surgery, Brown University School of Medicine, Providence, RI.
authors.forename: Joey P
authors.initials: JP
authors.lastname: Johnson
authors.affiliation: Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Sadlack
authors.affiliation: Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000628:therapy; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D019990:Perioperative Care; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000628:therapy; D017664:Uncompensated Care / Q000706:statistics & numerical data
keywords: arthroplasty; indigent; infection; protocol