Diagnosis and management of prosthetic joint infection

doi:10.1136/bmj.b1773

Published 29 May 2009, doi:10.1136/bmj.b1773
Cite this as: BMJ 2009;338:b1773

Clinical Review

Diagnosis and management of prosthetic joint infection

Philippa C Matthews, specialist registrar infectious diseases/microbiology, clinical research fellow¹^,2^,3, Anthony R Berendt, consultant in infectious diseases¹^,2, Martin A McNally, consultant orthopaedic surgeon in limb reconstruction¹, Ivor Byren, consultant in infectious diseases¹^,2

¹ Bone Infection Unit, Nuffield Orthopaedic Centre NHS Trust, Headington, Oxford OX3 7LD, ² Department of Infectious Diseases, Oxford Radcliffe Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford OX3 9DU, ³ University of Oxford, Peter Medawar Building for Pathogen Research, Oxford OX1 3SY

Correspondence to: P C Matthews p.matthews@doctors.org.uk

The first 150 words of the full text of this article appear below.

Joint replacement is safe, cost effective,¹ and widely undertaken.Most prosthetic joint replacements are hips and knees; morethan 130 000 people underwent such procedures in England andWales in the 12 months from April 2006.^w1 Subsequent prostheticjoint infection is uncommon—the incidence varies between0.6% and 2% per joint per year.² ³ ⁴ ⁵ However, this complicationis associated with substantial morbidity and economic cost ($30000 (£20 500; ${euro}$ 22 800) to $50 000 per patient).³ ⁴ ⁶ ^w2The diagnosis of prosthetic joint infection is difficult,^w2because symptoms, signs, and investigations may all be non-specific.⁷^w3 Defining diagnostic criteria and optimum management is complicatedby patient heterogeneity and the small numbers in many publishedstudies.^w4 However, prompt recognition and diagnosis of prostheticjoint infection facilitates timely intervention to salvage infectedjoints, preserve joint function, prevent morbidity, and reducecosts.

Early diagnosis of prosthetic joint infectionreduces morbidity and improves outcomes

Infection is eradicatedand joint . . . [Full text of this article]

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