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New IDSA guidelines aim to reduce death, disability, and cost of prosthetic joint infections
Date:12/6/2012

d is difficult to close, a plastic surgeon should be consulted, said Dr. Osmon. In rural areas with few specialists, doctors should consider consulting with infectious diseases specialists or orthopedists at referral centers.

The guidelines describe the best methods for diagnosis of prosthetic joint infections. These infections can be difficult to diagnose, and not all are obvious, notes Dr. Osmon. Also, problems with joint replacements particularly loosening of the prosthesis and pain may be caused by infection or by problems in the materials in the device itself.

Among the recommendations in the guidelines:

  • Physicians should suspect a prosthetic joint infection in a patient who has any of the following: persistent wound drainage in the skin over the joint replacement; sudden onset of a painful prosthesis, or ongoing pain after the prosthesis has been implanted, especially if there had been no pain for several years or if there is a history of prior wound healing problems or infections.

  • In patients with prosthetic joint infections:

    o Those with a well-fixed prosthesis without an open wound to the skin who had surgery less than 30 days previously are likely candidates for debridement, which means re-opening the incision and cleaning out the wound.

    o Those who have more extensive infection that has affected the bone and tissue may need to have the prosthesis replaced, either in the same surgery in which the prosthesis is removed, or in a later surgery.

    o Patients who cannot walk and who have limited bone stock, poor soft tissue coverage and infections due to highly resistant organisms may need to have the implants permanently removed. In some cases the joint may need to be fused.

    o Amputation of the limb may be necessary, but only as a last resort. Prior to amputation, the patient should be referred to a center with specialist experience in prosthetic joint infections, if his or her c
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Contact: Jerica Pitts
jpitts@pcipr.com
312-558-1770
Infectious Diseases Society of America
Source:Eurekalert

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