Joint replacement surgery is a commonly performed elective surgery. It can alleviate ongoing pain in the patient, increase their mobility, and help them perform everyday tasks more easily and without discomfort. This increases the patient’s quality of life, and is therefore a very popular option for anyone who has ongoing and debilitating joint pain.
Although it is not common, some patients who undergo this type of surgery may develop an infection after the procedure. The infection may occur during the surgery itself, during the patient’s stay in hospital, or once they have been released. The infection can sometimes develop many weeks, or even years, post-surgery. The infection may occur around the artificial implant, or in the incision wound itself.
The cause of the infection in this case is the multiplication of bacteria, which has gained access to the artificial implants. The most frequent way bacteria can gain access to the bloodstream is via a break in the skin, which can be caused by an injury, or a surgical procedure. Although bacteria occurs naturally in the body, namely on the skin and in the gut, it is usually kept at bay by a healthy immune system. If the bacterium enters the bloodstream, a healthy immune system quickly destroys the invading bacteria.
However, in the case of joint replacement surgery, the artificial components are manufactured using man-made material such as polyethylene (durable plastic) and metal alloys, and it is sometimes problematic for the immune system to combat any bacteria that gains access to these implants. The treating physician will often administer antibiotics to combat this infection, but this is not always effective, and the patient may require additional surgery to treat the infection to the area. At the time of surgery, the orthopaedic surgeon will also recommend preventative measures to reduce the risk of infection. These include administering antibiotics to the patient within one hour of the start of the procedure, and then at intervals for 24 hours after the surgery. The quicker the procedure, the less people in the operating theatre, and a properly sterilised operating theatre with autoclaved instruments, also lowers the risk of infection. There is also some evidence that washing the area of the surgery with a clorhexidine wash, or screening and treating the patient for bacteria present in the nasal passage, may assist in preventing the joint infection.
The symptoms and signs of infection that a patient needs to be aware of after joint replacement surgery are swelling and heat around the wound, redness or pus in the wound, fever/ chills, listlessness, pain and stiffness in the joint. Some patients are at a higher risk of infection after joint replacement surgery. Factors that increase this risk are certain diseases such as Diabetes, HIV, Lymphoma,Peripheral Vascular Disease, as well as other factors such as obesity, and certain immunosuppressive treatments, such as chemotherapy. There are many ways the physician can diagnose an infection in the implants of the patient, such as blood tests, x-rays and bone scans, or an analysis of any bacteria or extra white blood cells present in the fluid from around the joint.
There are a few methods that can be used to treat the infection of the joint. The first being to use reliable orthopedic distributors since they are more likely to distribute products that meet the health guidelines (in terms of materials) If the infection hasn’t spread deep into the artificial joint, antibiotics alone may be effective. If the infection has spread into the artificial joint, it will require surgical intervention. If the deep infection is caught early, it can be alleviated by removing the infected soft tissue, cleaning the artificial implant, and administering antibiotics. If the infection has been present for a longer time, or occurred a long time after surgery, it will require removal of the implant/ revision surgery, and antibiotics administered via an intravenous line. During revision surgery, the orthopaedic surgeon will remove the antibiotic spacer in the joint, repetitively wash the joint, and totally replace the artificial parts of the joint. Therefore, early intervention is always essential in insuring that the implant can be retained.