Skip to main content

Management of Infected Total Joint Arthroplasty

  • Chapter
  • First Online:
European Instructional Lectures

Part of the book series: European Instructional Lectures ((EICL,volume 14))

  • 943 Accesses

Abstract

Periprosthetic joint infection is one of the most challenging complications of total joint replacement surgery. Until very recently, the infection diagnosis was not clearly defined in the orthopaedic literature. This review outlines the new definition of periprosthetic joint infection, the utility of various clinical, serological and radiological tests in the prevention and diagnosis of infection. Treatment strategies and principles are also reviewed in the light of the current literature.

© EFORT 2014

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Schroer WC, Berend KR, Lombardi AV, Barnes CL, Bolognesi MP, Berend ME, Ritter MA, Nunley RM. Why are total knees failing today? Etiology of total knee revision in 2010 and 2011. J Arthroplasty. 2013;28(8 Suppl):116–19.

    Article  PubMed  Google Scholar 

  2. Parvizi J, Ghanem E, Menashe S, Barrack RL, Bauer TW. Periprosthetic infection: what are the diagnostic challenges? J Bone Joint Surg Am. 2006;88 Suppl 4:138–47.

    Article  PubMed  Google Scholar 

  3. Zimmerli W. Prosthetic joint infection: diagnosis and treatment. Curr Infect Dis Rep. 2000;2(5):377–9.

    Article  PubMed  Google Scholar 

  4. Spangehl MJ, Masri BA, O’Connell JX, Duncan CP. Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Joint Surg Am. 1999;81(5):672–83.

    CAS  PubMed  Google Scholar 

  5. Bedair H, Ting N, Jacovides C, Saxena A, Moric M, Parvizi J, Della Valle CJ. The Mark Coventry Award: diagnosis of early postoperative TKA infection using synovial fluid analysis. Clin Orthop Relat Res. 2011;469(1):34–40.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Schinsky MF, Della Valle CJ, Sporer SM, Paprosky WG. Perioperative testing for joint infection in patients undergoing revision total hip arthroplasty. J Bone Joint Surg Am. 2008;90(9):1869–75.

    Article  PubMed  Google Scholar 

  7. Parvizi J, Adeli B, Zmistowski B, Restrepo C, Greenwald AS. Management of periprosthetic joint infection: the current knowledge: AAOS exhibit selection. J Bone Joint Surg Am. 2012;94(14):e104.

    Article  PubMed  Google Scholar 

  8. Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG. New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res. 2011;469(11):2992–4.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Tang WM, Chiu KY, Ng TP, Yau WP, Ching PT, Seto WH. Efficacy of a single dose of cefazolin as a prophylactic antibiotic in primary arthroplasty. J Arthroplasty. 2003;18(6):714–18.

    Article  CAS  PubMed  Google Scholar 

  10. Parvizi J, Saleh KJ, Ragland PS, Pour AE, Mont MA. Efficacy of antibiotic-impregnated cement in total hip replacement. Acta Orthop. 2008;79(3):335–41.

    Article  PubMed  Google Scholar 

  11. Chiu FY, Lin CF. Antibiotic-impregnated cement in revision total knee arthroplasty. A prospective cohort study of one hundred and eighty-three knees. J Bone Joint Surg Am. 2009;91(3):628–33.

    Article  PubMed  Google Scholar 

  12. Dale H, Skramm I, Lower HL, Eriksen HM, Espehaug B, Furnes O, Skjeldestad FE, Havelin LI, Engesaeter LB. Infection after primary hip arthroplasty: a comparison of 3 Norwegian health registers. Acta Orthop. 2011;82(6):646–54.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Dale H, Fenstad AM, Hallan G, Havelin LI, Furnes O, Overgaard S, Pedersen AB, Karrholm J, Garellick G, Pulkkinen P, et al. Increasing risk of prosthetic joint infection after total hip arthroplasty. Acta Orthop. 2012;83(5):449–58.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Parvizi J, Gehrke T, Chen AF. Proceedings of the international consensus on periprosthetic joint infection. Bone Joint J. 2013;95-B(11):1450–2.

    Article  CAS  PubMed  Google Scholar 

  15. Dall GF, Simpson PM, Breusch SJ. In vitro comparison of Refobacin-Palacos R with Refobacin Bone Cement and Palacos R + G. Acta Orthop. 2007;78(3):404–11.

    Article  PubMed  Google Scholar 

  16. Greene N, Holtom PD, Warren CA, Ressler RL, Shepherd L, McPherson EJ, Patzakis MJ. In vitro elution of tobramycin and vancomycin polymethylmethacrylate beads and spacers from Simplex and Palacos. Am J Orthop. 1998;27(3):201–5.

    CAS  PubMed  Google Scholar 

  17. Meyer J, Piller G, Spiegel CA, Hetzel S, Squire M. Vacuum-mixing significantly changes antibiotic elution characteristics of commercially available antibiotic-impregnated bone cements. J Bone Joint Surg Am. 2011;93(22):2049–56.

    Article  PubMed  Google Scholar 

  18. Neut D, Kluin OS, Thompson J, van der Mei HC, Busscher HJ. Gentamicin release from commercially-available gentamicin-loaded PMMA bone cements in a prosthesis-related interfacial gap model and their antibacterial efficacy. BMC Musculoskelet Disord. 2011;11:258.

    Article  Google Scholar 

  19. Squire MW, Ludwig BJ, Thompson JR, Jagodzinski J, Hall D, Andes D. Premixed antibiotic bone cement: an in vitro comparison of antimicrobial efficacy. J Arthroplasty. 2008;23(6 Suppl 1):110–14.

    Article  PubMed  Google Scholar 

  20. Stevens CM, Tetsworth KD, Calhoun JH, Mader JT. An articulated antibiotic spacer used for infected total knee arthroplasty: a comparative in vitro elution study of Simplex and Palacos bone cements. J Orthop Res. 2005;23(1):27–33.

    Article  CAS  PubMed  Google Scholar 

  21. Cummins JS, Tomek IM, Kantor SR, Furnes O, Engesaeter LB, Finlayson SR. Cost-effectiveness of antibiotic-impregnated bone cement used in primary total hip arthroplasty. J Bone Joint Surg Am. 2009;91(3):634–41.

    Article  PubMed  Google Scholar 

  22. McLaren AC, Nugent M, Economopoulos K, Kaul H, Vernon BL, McLemore R. Hand-mixed and premixed antibiotic-loaded bone cement have similar homogeneity. Clin Orthop Relat Res. 2009;467(7):1693–8.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Miller R, McLaren A, Leon C, McLemore R. Mixing method affects elution and strength of high-dose ALBC: a pilot study. Clin Orthop Relat Res. 2012;470(10):2677–83.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Della Valle C, Parvizi J, Bauer TW, DiCesare PE, Evans RP, Segreti J, Spangehl M, Watters III WC, Keith M, Turkelson CM, et al. American Academy of Orthopaedic Surgeons clinical practice guideline on: the diagnosis of periprosthetic joint infections of the hip and knee. J Bone Joint Surg Am. 2011;93(14):1355–7.

    Article  PubMed  Google Scholar 

  25. Pill SG, Parvizi J, Tang PH, Garino JP, Nelson C, Zhuang H, Alavi A. Comparison of fluorodeoxyglucose positron emission tomography and (111)indium-white blood cell imaging in the diagnosis of periprosthetic infection of the hip. J Arthroplasty. 2006;21(6 Suppl 2):91–7.

    Article  PubMed  Google Scholar 

  26. Chryssikos T, Parvizi J, Ghanem E, Newberg A, Zhuang H, Alavi A. FDG-PET imaging can diagnose periprosthetic infection of the hip. Clin Orthop Relat Res. 2008;466(6):1338–42.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Berbari E, Mabry T, Tsaras G, Spangehl M, Erwin PJ, Murad MH, Steckelberg J, Osmon D. Inflammatory blood laboratory levels as markers of prosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am. 2010;92(11):2102–9.

    Article  PubMed  Google Scholar 

  28. Cipriano CA, Brown NM, Michael AM, Moric M, Sporer SM, Della Valle CJ. Serum and synovial fluid analysis for diagnosing chronic periprosthetic infection in patients with inflammatory arthritis. J Bone Joint Surg Am. 2012;94(7):594–600.

    Article  PubMed  Google Scholar 

  29. Ghanem E, Antoci Jr V, Pulido L, Joshi A, Hozack W, Parvizi J. The use of receiver operating characteristics analysis in determining erythrocyte sedimentation rate and C-reactive protein levels in diagnosing periprosthetic infection prior to revision total hip arthroplasty. Int J Infect Dis. 2009;13(6):e444–9.

    Article  CAS  PubMed  Google Scholar 

  30. Greidanus NV, Masri BA, Garbuz DS, Wilson SD, McAlinden MG, Xu M, Duncan CP. Use of erythrocyte sedimentation rate and C-reactive protein level to diagnose infection before revision total knee arthroplasty. A prospective evaluation. J Bone Joint Surg Am. 2007;89(7):1409–16.

    Article  PubMed  Google Scholar 

  31. Olshaker JS, Jerrard DA. The erythrocyte sedimentation rate. J Emerg Med. 1997;15(6):869–74.

    Article  CAS  PubMed  Google Scholar 

  32. Ghanem E, Parvizi J, Burnett RS, Sharkey PF, Keshavarzi N, Aggarwal A, Barrack RL. Cell count and differential of aspirated fluid in the diagnosis of infection at the site of total knee arthroplasty. J Bone Joint Surg Am. 2008;90(8):1637–43.

    Article  PubMed  Google Scholar 

  33. Della Valle C, Parvizi J, Bauer TW, Dicesare PE, Evans RP, Segreti J, Spangehl M, Watters III WC, Keith M, Turkelson CM, et al. Diagnosis of periprosthetic joint infections of the hip and knee. J Am Acad Orthop Surg. 2010;18(12):760–70.

    PubMed  Google Scholar 

  34. Spangehl MJ, Masterson E, Masri BA, O’Connell JX, Duncan CP. The role of intraoperative gram stain in the diagnosis of infection during revision total hip arthroplasty. J Arthroplasty. 1999;14(8):952–6.

    Article  CAS  PubMed  Google Scholar 

  35. Ghanem E, Ketonis C, Restrepo C, Joshi A, Barrack R, Parvizi J. Periprosthetic infection: where do we stand with regard to Gram stain? Acta Orthop. 2009;80(1):37–40.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Parvizi J, Ghanem E, Sharkey P, Aggarwal A, Burnett RS, Barrack RL. Diagnosis of infected total knee: findings of a multicenter database. Clin Orthop Relat Res. 2008;466(11):2628–33.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Bauer TW, Parvizi J, Kobayashi N, Krebs V. Diagnosis of periprosthetic infection. J Bone Joint Surg Am. 2006;88(4):869–82.

    Article  PubMed  Google Scholar 

  38. Wetters NG, Berend KR, Lombardi AV, Morris MJ, Tucker TL, Della Valle CJ. Leukocyte esterase reagent strips for the rapid diagnosis of periprosthetic joint infection. J Arthroplasty. 2012;27(8 Suppl):8–11.

    Article  PubMed  Google Scholar 

  39. Parvizi J, Walinchus L, Adeli B. Molecular diagnostics in periprosthetic joint infection. Int J Artif Organs. 2011;34(9):847–55.

    Article  CAS  PubMed  Google Scholar 

  40. Parvizi J, Jacovides C, Antoci V, Ghanem E. Diagnosis of periprosthetic joint infection: the utility of a simple yet unappreciated enzyme. J Bone Joint Surg Am. 2011;93(24):2242–8.

    Article  PubMed  Google Scholar 

  41. Jacovides CL, Parvizi J, Adeli B, Jung KA. Molecular markers for diagnosis of periprosthetic joint infection. J Arthroplasty. 2011;26(6 Suppl):99–103 e101.

    Article  PubMed  Google Scholar 

  42. Deirmengian C, Hallab N, Tarabishy A, Della Valle C, Jacobs JJ, Lonner J, Booth Jr RE. Synovial fluid biomarkers for periprosthetic infection. Clin Orthop Relat Res. 2010;468(8):2017–23.

    Article  PubMed Central  PubMed  Google Scholar 

  43. Segreti J, Nelson JA, Trenholme GM. Prolonged suppressive antibiotic therapy for infected orthopedic prostheses. Clin Infect Dis. 1998;27(4):711–13.

    Article  CAS  PubMed  Google Scholar 

  44. Rao N, Crossett LS, Sinha RK, Le Frock JL. Long-term suppression of infection in total joint arthroplasty. Clin Orthop Relat Res. 2003;414:55–60.

    Article  PubMed  Google Scholar 

  45. Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med. 2004;351(16):1645–54.

    Article  CAS  PubMed  Google Scholar 

  46. Koyonos L, Zmistowski B, Della Valle CJ, Parvizi J. Infection control rate of irrigation and debridement for periprosthetic joint infection. Clin Orthop Relat Res. 2011;469(11):3043–8.

    Article  PubMed Central  PubMed  Google Scholar 

  47. Parvizi J, Azzam K, Ghanem E, Austin MS, Rothman RH. Periprosthetic infection due to resistant staphylococci: serious problems on the horizon. Clin Orthop Relat Res. 2009;467(7):1732–9.

    Article  PubMed Central  PubMed  Google Scholar 

  48. Odum SM, Fehring TK, Lombardi AV, Zmistowski BM, Brown NM, Luna JT, Fehring KA, Hansen EN, Periprosthetic Infection C. Irrigation and debridement for periprosthetic infections: does the organism matter? J Arthroplasty. 2011;26(6 Suppl):114–18.

    Article  PubMed  Google Scholar 

  49. Gehrke T, Zahar A, Kendoff D. One-stage exchange: it all began here. Bone Joint J. 2013;95-B(11 Suppl A):77–83.

    Article  CAS  PubMed  Google Scholar 

  50. Manner P. CORR Insights(R): outcome of one-stage cementless exchange for acute postoperative periprosthetic hip infection. Clin Orthop Relat Res. 2013;471(10):3223–4.

    Article  PubMed  Google Scholar 

  51. Jenny JY, Barbe B, Gaudias J, Boeri C, Argenson JN. High infection control rate and function after routine one-stage exchange for chronically infected TKA. Clin Orthop Relat Res. 2013;471(1):238–43.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Winkler H. Rationale for one stage exchange of infected hip replacement using uncemented implants and antibiotic impregnated bone graft. Int J Med Sci. 2009;6(5):247–52.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  53. Friesecke C, Wodtke J. Periprosthetic knee infection. One-stage exchange. Orthopade. 2006;35(9):937–8, 940–5.

    Article  CAS  PubMed  Google Scholar 

  54. Garcia S, Soriano A, Esteban P, Almela M, Gallart X, Mensa J. Usefulness of adding antibiotic to cement in one stage exchange of chronic infection in total hip arthroplasty. Med Clin (Barc). 2005;125(4):138–9.

    Article  Google Scholar 

  55. Steinbrink K, Frommelt L. Treatment of periprosthetic infection of the hip using one-stage exchange surgery. Orthopade. 1995;24(4):335–43.

    CAS  PubMed  Google Scholar 

  56. Elson R. One-stage exchange in the treatment of the infected total hip arthroplasty. Semin Arthroplasty. 1994;5(3):137–41.

    CAS  PubMed  Google Scholar 

  57. Raut VV, Siney PD, Wroblewski BM. One-stage revision of total hip arthroplasty for deep infection. Long-term followup. Clin Orthop Relat Res. 1995;321:202–7.

    PubMed  Google Scholar 

  58. Cooper HJ, Della Valle CJ. The two-stage standard in revision total hip replacement. Bone Joint J. 2013;95-B(11 Suppl A):84–7.

    Article  CAS  PubMed  Google Scholar 

  59. Levine BR, Della Valle CJ, Hamming M, Sporer SM, Berger RA, Paprosky WG. Use of the extended trochanteric osteotomy in treating prosthetic hip infection. J Arthroplasty. 2009;24(1):49–55.

    Article  PubMed  Google Scholar 

  60. Morshed S, Huffman GR, Ries MD. Extended trochanteric osteotomy for 2-stage revision of infected total hip arthroplasty. J Arthroplasty. 2005;20(3):294–301.

    Article  PubMed  Google Scholar 

  61. Barrack RL, Berend KR, Cui Q, Fehring TK, Della Valle CJ, Gehrke T, Lombardi Jr AV, Mont MA, Parvizi J, Springer BD. Cement spacers in periprosthetic joint infection. Clin Infect Dis. 2013;57(2):328–9.

    Article  PubMed  Google Scholar 

  62. Van Thiel GS, Berend KR, Klein GR, Gordon AC, Lombardi AV, Della Valle CJ. Intraoperative molds to create an articulating spacer for the infected knee arthroplasty. Clin Orthop Relat Res. 2011;469(4):994–1001.

    Article  PubMed Central  PubMed  Google Scholar 

  63. Hofmann AA, Goldberg TD, Tanner AM, Cook TM. Ten-year experience using an articulating antibiotic cement hip spacer for the treatment of chronically infected total hip. J Arthroplasty. 2005;20(7):874–9.

    Article  PubMed  Google Scholar 

  64. Hsieh PH, Shih CH, Chang YH, Lee MS, Shih HN, Yang WE. Two-stage revision hip arthroplasty for infection: comparison between the interim use of antibiotic-loaded cement beads and a spacer prosthesis. J Bone Joint Surg Am. 2004;86-A(9):1989–97.

    PubMed  Google Scholar 

  65. Menge TJ, Koethe JR, Jenkins CA, Wright PW, Shinar AA, Miller GG, Holt GE. Acute kidney injury after placement of an antibiotic-impregnated cement spacer during revision total knee arthroplasty. J Arthroplasty. 2012;27(6):1221–7 e1221–2.

    Article  PubMed  Google Scholar 

  66. McGlothan KR, Gosmanova EO. A case report of acute interstitial nephritis associated with antibiotic-impregnated orthopedic bone-cement spacer. Tenn Med. 2012;105(9):37–40, 42.

    PubMed  Google Scholar 

  67. Joseph J, Raman R, Macdonald DA. Time interval between first and second stage revision hip arthroplasty for infection, the effect on outcome. J Bone Joint Surg Br. 2003;85-B(Suppl):58.

    Google Scholar 

  68. Glassman AH, Lachiewicz PF, Tanzer M, editors. Orthopaedic knowledge update 4: hip and knee reconstruction. 4th edn. Rosemont: American Academy of Orthopaedics; 2011.

    Google Scholar 

  69. Kusuma SK, Ward J, Jacofsky M, Sporer SM, Della Valle CJ. What is the role of serological testing between stages of two-stage reconstruction of the infected prosthetic knee? Clin Orthop Relat Res. 2011;469(4):1002–8.

    Article  PubMed Central  PubMed  Google Scholar 

  70. Larsson S, Thelander U, Friberg S. C-reactive protein (CRP) levels after elective orthopedic surgery. Clin Orthop Relat Res. 1992;275:237–42.

    PubMed  Google Scholar 

  71. Shukla SK, Ward JP, Jacofsky MC, Sporer SM, Paprosky WG, Della Valle CJ. Perioperative testing for persistent sepsis following resection arthroplasty of the hip for periprosthetic infection. J Arthroplasty. 2010;25(6 Suppl):87–91.

    Article  PubMed  Google Scholar 

  72. Pundiche M, Sarbu V, Unc OD, Grasa C, Martinescu A, Badarau V, Durbala I, Sapte E, Pasare R, Voineagu L, et al. Role of procalcitonin in monitoring the antibiotic therapy in septic surgical patients. Chirurgia (Bucur). 2012;107(1):71–8.

    CAS  Google Scholar 

  73. Parvizi J, Jacovides C, Antoci V, Ghanem E. Diagnosis of periprosthetic joint infection: the utility of a simple yet unappreciated enzyme. J Bone Joint Surg Am. 2012;93(24):2242–8.

    Google Scholar 

  74. Silvestre A, Almeida F, Renovell P, Morante E, Lopez R. Revision of infected total knee arthroplasty: two-stage reimplantation using an antibiotic-impregnated static spacer. Clin Orthop Surg. 2013;5(3):180–7.

    Article  PubMed Central  PubMed  Google Scholar 

  75. Azzam K, McHale K, Austin M, Purtill JJ, Parvizi J. Outcome of a second two-stage reimplantation for periprosthetic knee infection. Clin Orthop Relat Res. 2009;467(7):1706–14.

    Article  PubMed Central  PubMed  Google Scholar 

  76. Haddad FS, Masri BA, Campbell D, McGraw RW, Beauchamp CP, Duncan CP. The PROSTALAC functional spacer in two-stage revision for infected knee replacements. Prosthesis of antibiotic-loaded acrylic cement. J Bone Joint Surg Br. 2000;82(6):807–12.

    Article  CAS  PubMed  Google Scholar 

  77. Masri BA, Kendall RW, Duncan CP, Beauchamp CP, McGraw RW, Bora B. Two-stage exchange arthroplasty using a functional antibiotic-loaded spacer in the treatment of the infected knee replacement: the Vancouver experience. Semin Arthrop. 1994;5(3):122–36.

    CAS  Google Scholar 

  78. Romano CL, Gala L, Logoluso N, Romano D, Drago L. Two-stage revision of septic knee prosthesis with articulating knee spacers yields better infection eradication rate than one-stage or two-stage revision with static spacers. Knee Surg Sports Traumatol Arthrosc. 2012;20(12):2445–53.

    Article  CAS  PubMed  Google Scholar 

  79. Romano D, Drago L, Romano CL, Logoluso N. Does two-stage revision of septic hip prosthesis provides better infection eradication rate than one-stage? In: 14th EFFORT Congress, Istanbul, 2013.

    Google Scholar 

  80. Hansen E, Tetreault M, Zmistowski B, Della Valle CJ, Parvizi J, Haddad FS, Hozack WJ. Outcome of one-stage cementless exchange for acute postoperative periprosthetic hip infection. Clin Orthop Relat Res. 2013;471(10):3214–22.

    Article  PubMed  Google Scholar 

  81. Fink B, Grossmann A, Fuerst M, Schafer P, Frommelt L. Two-stage cementless revision of infected hip endoprostheses. Clin Orthop Relat Res. 2009;467(7):1848–58.

    Article  PubMed Central  PubMed  Google Scholar 

  82. Kalra KP, Lin KK, Bozic KJ, Ries MD. Repeat 2-stage revision for recurrent infection of total hip arthroplasty. J Arthroplasty. 2010;25(6):880–4.

    Article  PubMed  Google Scholar 

  83. Pagnano MW, Trousdale RT, Hanssen AD. Outcome after reinfection following reimplantation hip arthroplasty. Clin Orthop Relat Res. 1997;338:192–204.

    Article  PubMed  Google Scholar 

  84. Mortazavi SM, Vegari D, Ho A, Zmistowski B, Parvizi J. Two-stage exchange arthroplasty for infected total knee arthroplasty: predictors of failure. Clin Orthop Relat Res. 2011;469(11):3049–54.

    Article  PubMed Central  PubMed  Google Scholar 

  85. Zmistowski B, Fedorka CJ, Sheehan E, Deirmengian G, Austin MS, Parvizi J. Prosthetic joint infection caused by gram-negative organisms. J Arthroplasty. 2011;26(6 Suppl):104–8.

    Article  PubMed  Google Scholar 

  86. Zmistowski B, Tetreault MW, Alijanipour P, Chen AF, Della Valle CJ, Parvizi J. Recurrent periprosthetic joint infection: persistent or new infection? J Arthroplasty. 2013;28(9):1486–9.

    Article  PubMed  Google Scholar 

  87. Casanova D, Hulard O, Zalta R, Bardot J, Magalon G. Management of wounds of exposed or infected knee prostheses. Scand J Plast Reconstr Surg Hand Surg. 2001;35(1):71–7.

    Article  CAS  PubMed  Google Scholar 

  88. Leung F, Richards CJ, Garbuz DS, Masri BA, Duncan CP. Two-stage total hip arthroplasty: how often does it control methicillin-resistant infection? Clin Orthop Relat Res. 2011;469(4):1009–15.

    Article  PubMed Central  PubMed  Google Scholar 

  89. Rasouli MR, Tripathi MS, Kenyon R, Wetters N, Della Valle CJ, Parvizi J. Low rate of infection control in enterococcal periprosthetic joint infections. Clin Orthop Relat Res. 2012;470(10):2708–16.

    Article  PubMed Central  PubMed  Google Scholar 

  90. Ballard WT, Lowry DA, Brand RA. Resection arthroplasty of the hip. J Arthroplasty. 1995;10(6):772–9.

    Article  CAS  PubMed  Google Scholar 

  91. Bejon P, Berendt A, Atkins BL, Green N, Parry H, Masters S, McLardy-Smith P, Gundle R, Byren I. Two-stage revision for prosthetic joint infection: predictors of outcome and the role of reimplantation microbiology. J Antimicrob Chemother. 2010;65(3):569–75.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  92. Filice GA, Nyman JA, Lexau C, Lees CH, Bockstedt LA, Como-Sabetti K, Lesher LJ, Lynfield R. Excess costs and utilization associated with methicillin resistance for patients with Staphylococcus aureus infection. Infect Control Hosp Epidemiol. 2010;31(4):365–73.

    Article  PubMed  Google Scholar 

  93. Husted H, Toftgaard Jensen T. Clinical outcome after treatment of infected primary total knee arthroplasty. Acta Orthop Belg. 2002;68(5):500–7.

    CAS  PubMed  Google Scholar 

  94. Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, Rao N, Hanssen A, Wilson WR. Infectious Diseases Society of A: Executive summary: diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2013;56(1):1–10.

    Article  PubMed  Google Scholar 

  95. Rand JA, Bryan RS, Chao EY. Failed total knee arthroplasty treated by arthrodesis of the knee using the Ace-Fischer apparatus. J Bone Joint Surg Am. 1987;69(1):39–45.

    CAS  PubMed  Google Scholar 

  96. Senthi S, Munro JT, Pitto RP. Infection in total hip replacement: meta-analysis. Int Orthop. 2011;35(2):253–60.

    Article  PubMed Central  PubMed  Google Scholar 

  97. Conway JD, Mont MA, Bezwada HP. Arthrodesis of the knee. J Bone Joint Surg Am. 2004;86-A(4):835–48.

    PubMed  Google Scholar 

  98. Isiklar ZU, Landon GC, Tullos HS. Amputation after failed total knee arthroplasty. Clin Orthop Relat Res. 1994;299:173–8.

    PubMed  Google Scholar 

  99. Sierra RJ, Trousdale RT, Pagnano MW. Above-the-knee amputation after a total knee replacement: prevalence, etiology, and functional outcome. J Bone Joint Surg Am. 2003;85-A(6):1000–4.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Burak Beksaç MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 EFORT

About this chapter

Cite this chapter

Beksaç, B. (2014). Management of Infected Total Joint Arthroplasty. In: Bentley, G. (eds) European Instructional Lectures. European Instructional Lectures, vol 14. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54030-1_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-54030-1_4

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-54029-5

  • Online ISBN: 978-3-642-54030-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics