Cismașiu R.S. 1, Vasile Laura 2
1 Department of Orthopaedic Surgery, Clinical Hospital of Orthopaedics and Traumatology “Foișor”, Bucharest, Romania
2 Department of Microbiology, Clinical Hospital of Orthopaedics and Traumatology “Foișor”, Bucharest, Romania
Abstract
Peri-prosthetic joint infection (PJI) is a major and severe complication after joint replacement. Although it occurs in a small percentage (1-3%) of patients undertaking arthroplasty it results in substantial morbidity and a decline of the final functional outcome. Therefore, deep peri-prosthetic joint infections lead to a significant both clinic, but also economic burden regarding diagnosis and treatment. Paper goal. The aim of the present article is to retrospectively analyse and evaluate the rate, diagnosis procedures and treatment management and results of the peri-prosthetic joint infections (PJI) in our hospital. Material and method. Between 2007 and 2010, in the Clinical Hospital of Orthopaedics and Traumatology “Foișor”, we identified a total of 96 peri-prostetic joint infection (PJI) episodes in 89 patients. We analysed the cases from diagnostic and treatment management point of view and withdraw conclusions reported to the actual peri-prosthetic joint infection (PJI) guideline. Results. The overall prevalence rate of peri-prosthetic joint infection (PJI) after THR and TKR together was 2.87%, but however higher in TKR (3.30%) than in THR (2.70%). The diagnostic protocol led to a specific antibiogram in 90% of the cases. Except early infections cases, the treatment attitude was “two-stage” revision for late, haematogenous or intraoperative infection, with a success rate of 87.50%. Conclusions. The “two stage” exchange revision arthroplasty seems to be a successful procedure in the treatment of peri-prosthetic joint infection (PJI) and therefore we recommend this surgical attitude in similar cases of infection. As final remark, early recognition and proper management of these infections is important, not only from a medico-legal standpoint, but also from the significant implications of this pathologic entity upon public health and economic costs.