Results of periprosthetic hip and knee infections caused by resistant bacteria

Clin Orthop Relat Res. 2002 Nov:(404):116-24. doi: 10.1097/00003086-200211000-00021.

Abstract

Seventy patients with deep periprosthetic hip or knee infections were treated between May 1997 and March 2001. Thirty-five patients had periprosthetic infections of their total hip arthroplasties and 35 patients had periprosthetic infections of their total knee arthroplasties. The patients were subdivided into two subgroups: patients who had infections with Staphylococcal bacterial strains that were sensitive to methicillin and patients who had infections with bacteria that were resistant to methicillin (methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis). Treatment was considered successful if the patient was able to retain his or her hip or knee prosthesis either as a result of irrigation and debridement procedures alone or after excision of the infected total hip or knee prosthesis followed by successful reimplantation. Treatment was considered a failure if the patient eventually required arthrodesis, amputation, or was left with a permanent excision arthroplasty. Hip replacements that were infected with antibiotic-sensitive bacteria were treated successfully in 81% of cases. In contrast, hip replacements infected with resistant organisms were treated successfully in only 48% of cases. Similarly, knee replacements infected with sensitive organisms had a success rate of 89%, compared with only 18% of the total knee replacements that were infected with resistant bacterial strains.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Debridement
  • Female
  • Hip Prosthesis / adverse effects*
  • Humans
  • Knee Prosthesis / adverse effects*
  • Male
  • Methicillin Resistance*
  • Middle Aged
  • Prosthesis-Related Infections / microbiology*
  • Prosthesis-Related Infections / therapy
  • Reoperation
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology*
  • Staphylococcal Infections / therapy*
  • Staphylococcus aureus / drug effects
  • Staphylococcus epidermidis / drug effects
  • Therapeutic Irrigation
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents