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Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Evaluation and Treatment of Infection at the Site of a Total Hip or Knee Arthroplasty*

ARLEN D. HANSSEN, M.D., ROCHESTER, MINNESOTA and JAMES A. RAND, M.D., SCOTTSDALE, ARIZONA

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

	Introduction

 
Infection following total joint replacement remains a major problem that has not been solved during the last thirty years. The prevalence of infection at the Mayo Clinic between 1969 and 1996 was 1.7 per cent of 30,680 total hip arthroplasties and 2.5 per cent of 18,749 total knee arthroplasties. After primary operations, the rate of infection was 1.3 per cent of 23,519 hips and 2.0 per cent of 16,035 knees. After revision operations, the rate was 3.2 per cent of 7161 hips and 5.6 per cent of 2714 knees (Table I). The rate of infection has been remarkably constant despite the use of different regimens of antibiotic prophylaxis, operating-room configurations, operative techniques, and modes of fixation of the implant. Factors leading to deep infection must be considered with respect to the host, wound, operative technique, operating-room environment, and microbiological characteristics of the infecting organisms. A prompt diagnosis of . . . [Full Text of this Article]

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