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The Journal of Bone and Joint Surgery 78:458-71 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Prevention of Deep Periprosthetic Joint Infection*{dagger}

ARLEN D. HANSSEN, M.D.{ddagger}, DOUGLAS R. OSMON, M.D.{ddagger}, ROCHESTER, MINNESOTA and CARL L. NELSON, M.D.§, LITTLE ROCK, ARKANSAS

An Instructional Course Lecture, The American Academy of Orthopaedic Surgeons


   Introduction
 
Although the prevalence of postoperative deep wound infection after total joint arthroplasty has decreased over the past few decades, it remains a feared consequence for both surgeons and patients107. Moynihan stated that "every operation in surgery is an experiment in bacteriology."80 This statement provides remarkable insight into the seemingly variable and unpredictable nature of infection. Often, the specific mechanism and timing of bacterial delivery in a given wound is unknown, and it is usually extremely difficult to prove the exact cause of the infection in an individual situation. Despite improved outcomes of treatment for established deep periprosthetic infection, prevention remains a meaningful objective. The estimated cost of treatment67 of an infection at the site of a total hip or total knee arthroplasty exceeds $50,000.

A thorough appreciation of and respect for the innumerable factors that may contribute to an infection is essential in the development of an over-all approach . . . [Full Text of this Article]


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