Skip to main content
main-content

05.06.2018 | Orthopaedic Surgery | Ausgabe 9/2018

Archives of Orthopaedic and Trauma Surgery 9/2018

An often-unrecognized entity as cause of recurrent infection after successfully treated two-stage exchange arthroplasty: hematogenous infection

Zeitschrift:
Archives of Orthopaedic and Trauma Surgery > Ausgabe 9/2018
Autoren:
Doruk Akgün, Michael Müller, Carsten Perka, Tobias Winkler

Abstract

Introduction

Reinfection after two-stage exchange arthroplasty is a difficult clinical scenario with limited data on adequate treatment algorithms. Beside the possibility of treatment failure and a new intraoperative infection at the time of reimplantation, hematogenous seeding could play an up to date underestimated crucial role as another cause of an infection after two-stage exchange. The aim of this study was to evaluate its incidence and treatment possibilities in a prospectively followed case series.

Methods

All consecutive hip and knee periprosthetic joint infection cases (93 hips and 89 knees) treated according to a standardized diagnostic and therapeutic algorithm at our institution with a two-stage exchange arthroplasty from 2013 to 2015 were included and followed prospectively to identify recurrent infections due to hematogenous seeding.

Results

Six percent from our septic revision hip and knee arthroplasties (11 of 182, including 5 hips and 6 knees) were identified with a hematogenous reinfection after a mean follow-up of 31.8 months (range 14–48 months). The mean time to reinfection after reimplantation was 12.2 months (range 3.1–35.1). In all but two cases was the causative microorganism different than isolated at the time of initial two-stage exchange. In 5 of 11 patients, the primary focus of infection was identified.

Conclusion

Hematogenous infection after a successful two-stage exchange arthroplasty is a rare but very important cause of a reinfection. With our work, we aim at raising the awareness for this entity and recommend consideration of irrigation and debridement with implant retention in these cases, as well as possibly the identification of a primary infection source.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Bis zum 22.10. bestellen und 100 € sparen!

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 9/2018

Archives of Orthopaedic and Trauma Surgery 9/2018 Zur Ausgabe
  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Orthopädie und Unfallchirurgie

 

 

 
 

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise