Prosthetic joint infections

One of the main risk factors would be infection of the surgical wound. In other instances, when one develops a bloodstream infection from other sites of infection (e.g. urine infection or skin infection), bacteria may seed the prosthetic joint and the joint can get secondarily infection. 

Other risk factors for prosthetic joint infection include: advanced age, cancer, poor immunity (autoimmune conditions and diabetes) and previous joint replacement or previous joint infection. 

Treatment is multi-disciplinary, usually involving the Infectious Disease specialist as well as the Orthopaedic surgeon. 

Prosthetic joint infection treatment is with both surgery AND antibiotics. 

Surgical options include resection arthroplasty with reimplantation (in one or two stages), debridement and retention of prosthesis, or resection arthroplasty in the absence of subsequent hardware implantation. Surgical amputation for prosthetic joint infection is extremely uncommon. 

For antibiotic therapy, often, a prolonged course of antibiotics, typically 6 weeks is required. These antibiotics are usually given intravenously. The insertion of a long term venous catheter for antibiotic infusion is recommended; and this may be may be administered in the hospital or through the outpatient parental antibiotic therapy (OPAT) clinic.  In some individuals treated with debridement and retention of prosthesis, a long term course of oral antimicrobiotics may be required to prevent the prosthetic joint infection from flaring. Duration of antibiotic therapy varies for each person depending on the clinical picture, and should be made in consult with the infectious diseases physician.