Prosthetic joint infections: outcome after treatment in a case series

Abstract

Prosthetic joint infections (PJI) are one of the most complication of joint replacement surgery and report a considerable disability and cost. This complication occurs in 0.8-1.9% of knee prostheses (TKA) and 0.3-1.7% of hip replacement (THA) [1]. These percentages may be underestimated because of the ability of some bacteria to grow in community of aggregation on the surface of the prosthesis, defined biofilm, which makes difficult their isolation by standard culture tests. In fact, in a significant percentage of prosthetic infections, the responsible agent remains unknown, and this may affect the outcome [2,3]. The classification of implant-associated infections is related to the onset of symptoms after implantation. Early infection is defined as appearance of the first signs and symptoms of infection during the first 3 months after surgery. However, some authors limit these surgical site infection to the first 4- weeks [4]. Delayed manifestation is defined as an infection in which the first signs and symptons appear between 3months and 2 years post-surgery, and late manifestation is defined as the appearance of first signs and symptons of infection > 2 years post- surgery. Each type has specific etiopathogenic properties that influence the therapeutic options. Outcome data on treatment are limited. Aim of this study was to evaluate the characteristics of patients with PJI and their outcome after treatment.