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Diagnosis and Management of Hip Disease pp 249–271Cite as

Hip Sepsis and the Prevention of Perioperative Infections

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Abstract

Total hip arthroplasty (THA) is a very successful surgical procedure; however, periprosthetic joint infection (PJI) is a devastating complication after total joint arthroplasty (TJA). The incidence of deep infection has declined, but the total number of infections is increasing because of significant increases in the number of hip and knee surgeries performed each year.

Recent improvements in perioperative techniques have enabled operation on patients with higher infection risk factors and comorbidities; however, the emergence of resistant bacterial strains represents a challenge in preventing deep infection.

Infection risk can be reduced by optimizing modifiable factors related to the preoperative, surgical, and postoperative periods including patient-related and environmental factors and surgical technique. Malnourished or anemic patients, those with chronic diseases, or those with tobacco and alcohol abuse represent special risk groups. The principles of infection prevention in these patients are well-documented, but adherence to surgical and postoperative care protocols should be improved. In order to control PJI, identification of modifiable risk factors must be the first, essential part of current infection prevention practices.

This chapter identifies common, modifiable risk factors and defines strategies for optimizing and caring for patients pre-, peri-, and post-operatively that may help to further reduce deep infection rates.

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Abbreviations

AAOS:

American Academy of Orthopaedic Surgeons

CHG:

Chlorhexidine gluconate

CRF:

Chronic renal failure

DM:

Diabetes mellitus

DMARDs:

Disease-modifying anti-rheumatic drugs

IJD:

Inflammatory joint disease

INR:

International normalized ratio

MIC:

Minimal Inhibitory Concentrations

MRSA:

Methicillin resistant staphylococcus aureus

MSIS:

The Musculoskeletal Infection Society

OR:

Operating room

PJI:

Periprosthetic joint infection

RA:

Rheumatoid Arthritis

SSI:

Surgical site infection

THA:

Total hip arthroplasty

TJA:

Total joint arthroplasty

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Rothman Institute at Thomas Jefferson University, The Sheridan Building, 10th Floor 125 S. 9th Street, Suite 1000, Philadelphia, PA, 19107, USA

    Javad Parvizi MD, FRCS & Fatih Küçükdurmaz MD

  2. Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey

    Javad Parvizi MD, FRCS & Fatih Küçükdurmaz MD

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  1. Javad Parvizi MD, FRCS
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  2. Fatih Küçükdurmaz MD
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Correspondence to Javad Parvizi MD, FRCS .

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  1. Department of Orthopedics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

    Roy K. Aaron

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Parvizi, J., Küçükdurmaz, F. (2015). Hip Sepsis and the Prevention of Perioperative Infections. In: Aaron, R. (eds) Diagnosis and Management of Hip Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-19905-4_12

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