Prosthetic Joint Infection: When Can Prosthesis Salvage Be Considered?

• Published in: Clinical infectious diseases Vol. 29; no. 2; pp. 292 - 295
• Main Authors: Tattevin, Pierre, Crémieux, Anne-Claude, Pottier, Pierre, Huten, Denis, Carbon, Claude
• Format: Journal Article
• Language: English
• Published: United States The University of Chicago Press 01-08-1999; University of Chicago Press
• Subjects: Adult; Aged; Aged, 80 and over; Arthroplasty; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Knee - adverse effects; Clinical Articles; Debridement; Female; Follow-Up Studies; Hip; Humans; Infections; Joint prostheses; Male; Medical treatment; Medical treatment failures; Middle Aged; Pathogens; Prosthesis-Related Infections - microbiology; Prosthesis-Related Infections - therapy; Prosthetics; Retrospective Studies; Staphylococcal Infections - therapy; Symptoms
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/520202

Management of prosthetic joint infection (PJI) remains a therapeutic challenge. We retrospectively studied 69 infected total hip or knee arthroplasties managed between 1980 and 1996 in our institution. Treatment failure, defined as relapse of PJI in the first year following the last antimicrobial treatment, occurred for 14 patients (20.3%). None of the potentially contributive parameters analyzed was significantly predictive of treatment failure. Of the subgroup of 34 patients with PJI who initially underwent debridement with retention of the prosthesis, the 13 (38.2%) who did not require further surgical treatment had symptoms for a significantly shorter duration before debridement (4.85 vs. 54.24 days; P < .0001). Because debridement with retention of the prosthesis rarely enables control of PJI, this therapeutic approach should be considered only when the duration of symptoms is very short.