Zdravniški Vestnik (Feb 2007)
Prevfention and principles of treatment prosthetic joint infections
Abstract
Background: The infections of joint endoprostheses are relatively rare but they represent a major complication after the insertion of the artificial joint. For this reason it is very important to take measures in order to prevent these infections. The measures consist of the following procedures: the preparation of the patient for the operation, the perioperative antibiotic protection and the postoperative prevention of possible later hematogenically occurring infections. The aims of the treatment of prosthetic infections are to stop or alleviate the inflammation, to prevent or reduce the chance of reoccurrence and to prevent a permanent, chronic infection. Clinically we try to achieve a functionally good result. The treatment is normally a combination of a surgical and a long-term antibiotic treatment. The patients with a stable implant, short-lived endoprosthetic infection with a microorganism susceptible to an antimicrobial agent can be successfully treated with debridement and specific antibiotics. In all other patients with a long-lived endoprosthetic infection and loose implant a more invasive procedure such as one-stage or even two-stage exchange has to be chosen.Conclusions: The treatment of orthopaedic implants is demanding and complicated. Therefore we think that such patients can get proper medical care only in specialized medical centres. When the right treatment procedure has been chosen the prospects of a successful treatment outcome are favourable.
