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OUR EXPERIENCES IN TREATMENT OF PROSTHETIC JOINT INFECTIONS



Abstract

Aims: Prosthetic joint infections are relatively rare but represent one of the major complications. The aim of the treatment of prosthetic joint infections are to stop or alleviate inflammation, to prevent or reduce the chance of reoccurrence and to prevent a permanent, chronic infection.

Patients and Methods: We analysed data of patients who were treated accordingly to the Liestal protocol in our orthopaedic department from January 2000 to December 2006. The combination of surgical and antibiotic treatment was used. The patients with a stable implant, short-lived prosthetic joint infection caused by microorganisms (susceptible to some antimicrobial agent) were successfully treated with early radical debridement and appropriate antibiotics. In patients with loose implant and long-lived prosthetic joint infection a more invasive procedure such as one-stage or even two-stage exchange was performed.

Results: During 7-years period 44 patients (27 females, 17 males; aged from 40 to 85 years) were treated for prosthetic joint infection at our department. There were 37 infections after primary operations, and 7 after revisions. According to type of the treatment we performed debridement with retention in 19 cases (64% success rate), one-stage successful exchange in one case, and two-stage exchange in 9 cases (89% success rate). Primary Girdlstone or knee arthrodesis both in one case and one hip exarticulation and 2 knee amputations represent difficult cases with poor outcome.

Conclusions: Treatment of prosthetic joint infections is very complicated but using the proper treatment protocol we can achieve successful outcome.

Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Email: office@efort.org