[Diagnosis and treatment of foreign-body-associated infection in orthopaedic surgery]. Orthopade 2009 Sep;38(9):806-11
Date
09/17/2009Pubmed ID
19756495DOI
10.1007/s00132-009-1450-6Scopus ID
2-s2.0-77956341146 (requires institutional sign-in at Scopus site) 21 CitationsAbstract
Periprosthetic infection is a foreign-body-associated infection that is characterised by delayed osteomyelitis of bone tissue surrounding artificial joint replacement. Most of these infections result from intraoperative bacterial contamination of the prosthetic device implanted. The period from contamination to clinically apparent infection can last months or even years. In these cases, the initial surgical procedure is often not blamed for the actual infection. Moreover, these infections often produce minimal symptoms that can be mistaken for aseptic loosening of the artificial joint replacement. The bacterial burden of the causative pathogen is low in these cases, a fact that need to be considered in the diagnostic procedures.Knowledge of the pathogenesis allows the orthopaedic surgeon to plan the diagnostic procedures and therapy as well. In this context, the pathogen's ability to form biofilm is of crucial significance and explains why it is necessary to remove the foreign body (prosthesis or other artificial devices, such as material used for osteosynthesis or spinal stabilisation) to control this type of infection. This article gives some basic information for better understanding of foreign-body-associated infection in order to improve diagnostics and therapy in the clinical routine.
Author List
Frommelt LMESH terms used to index this publication - Major topics in bold
Anti-Bacterial AgentsBiofilms
Biopsy
Chronic Disease
Combined Modality Therapy
Diagnosis, Differential
Drug Resistance, Multiple, Bacterial
Hip Prosthesis
Humans
Inflammation Mediators
Knee Prosthesis
Osteomyelitis
Predictive Value of Tests
Prosthesis Failure
Prosthesis-Related Infections
Reoperation
