Acta Chir Orthop Traumatol Cech. 2006; 73(4):229-236 | DOI: 10.55095/achot2006/033

Current Strategies for Prevention of Prosthetic Joint InfectionCurrent concepts review

J. GALLO1,*, I. LANDOR2, P. VAVŘÍK2
1 Ortopedická klinika LF UP a FN Olomouc
2 I. ortopedická klinika 1. LF UK, Praha

Deep sepsis still remains the second most common cause of prosthetic joint failure despite its overall incidence is decreasing. It can be defined as a bacterial growth and replication on the prosthetic joint surface resulting in periprosthetic tissue damage and prosthesis loosening. The implants are colonized by airborne-, skin-, tool-, and/ or surgeon-related bacteria during surgery even though majority of procedures are performed under strictly respected conditions nowadays. After the insertion of the prosthesis into the human body the race between bacteria and host cells begins on what will colonize the prosthetic surface first. If the bacteria are more successful then they develop on formation of biofilm which is the biological correlative for the prosthetic joint infection (PJI) resisting effectively against host immune response and antibiotics. That is why preventative measures are strongly worth to do it, and removal of the prosthesis is the single optimal treatment. Each step in the pathogenesis of prosthetic joint infection may represent relevant targets against which prevention strategies may be directed. Of them the most useful seems to be identification of individual factors predisposing for PJI development, antibiotic prophylaxis given before the surgery, and operating room/ surgical quality parameters.

Keywords: prevention, prosthetic joint infection, deep sepsis, biofilm, total joint replacement

Accepted: March 2, 2006; Published: August 1, 2006  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
GALLO J, LANDOR I, VAVŘÍK P. Current Strategies for Prevention of Prosthetic Joint Infection. Acta Chir Orthop Traumatol Cech. 2006;73(4):229-236. doi: 10.55095/achot2006/033. PubMed PMID: 17026881.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. AMERICAN UROLOGICAL ASSOCIATION, AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS: Antibiotic prophylaxis for urological patients with total joint replacements. J. Urol., 169: 1796-1797, 2003. Go to original source... Go to PubMed...
    2. BARIE, P. S.: Surgical site infections: epidemiology and prevention. Surg. Infect. (Larchmt), 3 (Suppl. 1): S9-21, 2002. Go to original source... Go to PubMed...
    3. BENGTSON, S., KNUTSON, K.: The infected knee arthroplasty. A 6-year follow-up of 357 cases. Acta orthop. scand., 62: 301-311, 1991. Go to original source... Go to PubMed...
    4. BERBARI, E. F., HANSSEN, A. D., DUFFY, M. C., STECKELBERG, J. M., ILSTRUP, D. M., HARMSEN, W. S., OSMON, D. R.: Risk factors for prosthetic joint infection: case-control study. Clin. Infect. Dis., 27: 1247-1254, 1998. Go to original source... Go to PubMed...
    5. BRATZLER, D. W., HOUCK, P.M., RICHARDS, C., STEELE, L., DELLINGER, E.P., FRY, D.E., WRIGHT, C. et al.: Use of antimicrobial prophylaxis for major surgery: baseline results from the National Surgical Infection Prevention Project. Arch. Surg., 140: 174-182, 2005. Go to original source... Go to PubMed...
    6. BRAUSE, B. D.: Microbes and antibiotics. In: The Adult Knee. Callaghan, J. J., Rosenberg, A.G., Rubash, H.E., Simonian, P.T., Wickiewicz, T.L. (eds.). Philadelphia, Lippincott Williams and Wilkins 2003.
    7. COSTERTON, J. W.: Biofilm theory can guide the treatment of device-related orthopaedic infections. Clin. Orthop., 437: 7-11, 2005. Go to original source... Go to PubMed...
    8. ČECH, O., PAVLANSKÝ, R.: Aloplastika kyčelního kloubu. Praha, Avicenum 1979.
    9. DEACON, J. M., PAGLIARO, A. J., ZELICOF, S. B., HOROWITZ, H. W.: Prophylactic use of antibiotics for procedures after total joint replacement. J. Bone Jt Surg., 78-A: 1755-1770, 1996. Go to original source... Go to PubMed...
    10. ENGESAETER, L. B., LIE, S. A., ESPEHAUG, B., FURNES, O., VOLLSET, S. E., HAVELIN, L. I.: Antibiotic prophylaxis in total hip arthroplasty: effects of antibiotic prophylaxis systemically and in bone cement on the revision rate of 22,170 primary hip replacements followed 0-14 years in the Norwegian Arthroplasty Register. Acta Orthop. Scand., 74: 644-651, 2003. Go to original source... Go to PubMed...
    11. ESLER, C. N., BLAKEWAY, C., FIDDIAN, N. J.: The use of a closed-suction drain in total knee arthroplasty. A prospective, randomised study. J. Bone Jt Surg., 85-B: 215-217, 2003. Go to original source... Go to PubMed...
    12. FITZGERALD, R. H., Jr., NOLAN, D. R., ILSTRUP, D. M., VAN SCOY, R. E., WASHINGTON, J. A., II, COVENTRY, M. B.: Deep wound sepsis following total hip arthroplasty. J. Bone Jt Surg., 59: 847-855, 1977. Go to original source...
    13. GALLO, J., KOLÁŘ, M., ŘIHÁKOVÁ, P., TICHÁ, V.: Pathogenesis of prosthesis-related infection. A review. Biomed. Papers, 147: 27-35, 2003. Go to original source... Go to PubMed...
    14. GEUBBELS, E. L., WILLE, J. C., NAGELKERKE, N. J., VANDENBROUCKE-GRAULS, C. M., GROBBEE, D. E., DE BOER, A. S.: Hospital-related determinants for surgical-site infection following hip arthroplasty. Infect. Control Hosp. Epidemiol., 26: 435-441, 2005. Go to original source... Go to PubMed...
    15. GRISTINA, A. G., NAYLOR, P.T., WEBB, L.X.: Molecular mechanism in musculoskeletal sepsis: The race for the surface. Instr. Course Lect. (AAOS), 39: 471-486, 1990.
    16. HANSSEN, A. D.: Prophylactic use of antibiotic bone cement. J. Arthroplasty, 19 (Suppl. 1): 73-77, 2004. Go to original source... Go to PubMed...
    17. HASSINGER, S. M., HARDING, G., WONGWORAWAT, M. D.: High-pressure pulsatile lavage propagates bacteria into soft tissue. Clin. Orthop., 439: 27-31, 2005. Go to original source... Go to PubMed...
    18. HAVELIN, L. I., ENGESAETER, L. B., ESPEHAUG, B., FURNES, O., LIE, S. A., VOLLSET, S. E.: The norwegian arthroplasty register: 11 years and 73,000 arthroplasties. Acta orthop. scand., 71: 337-353, 2000. Go to original source... Go to PubMed...
    19. CHARNLEY, J., CUPIC, Z.: The nine and ten year results of the low-friction arthroplasty of the hip. Clin. Orthop., 95: 9-25, 1973. Go to original source...
    20. INNERHOFER, P., KLINGLER, A., KLIMMER, C., FRIES, D., NUSSBAUMER, W.: Risk for postoperative infection after transfusion of white blood cell-filtered allogeneic or autologous blood components in orthopedic patients undergoing primary arthroplasty. Transfusion, 45: 103-110, 2005. Go to original source... Go to PubMed...
    21. IORIO, R., WHANG, W., HEALY, W. L., PATCH, D. A., NAJIBI, S., APPLEBY, D.: The utility of bladder catheterization in total hip arthroplasty. Clin. Orthop., 432: 148-152, 2005. Go to original source... Go to PubMed...
    22. JACOBSON, C., OSMON, D. R., HANSSEN, A., TROUSDALE, R. T., PAGNANO, M. W., PYREK, J., BERBARI, E., NAESSENS, J.: Prevention of wound contamination using DuraPreptrade mark solution plus Iobantrade mark 2 drapes. Clin. Orthop., 439: 32-37, 2005. Go to original source... Go to PubMed...
    23. JAHODA, D., SOSNA, A., LANDOR, I., VAVŘÍK, P., POKORNÝ, D., HUDEC, T.: Dvojdobá reimplantace za použití spaceru - metoda volby při řešení infekce náhrady kyčelního kloubu. Srovnání metod použitých v letech 1979 až 1998. Acta Chir. orthop. Traum. čech., 70: 17-24, 2003.
    24. JAHODA, D., VAVŘÍK, P., LANDOR, I., POKORNÝ, D.: Řešení infekce náhrady kolenního kloubu u pacientů s revmatoidní arthritidou. Čes. Revmatol., 8: 83-90, 2000.
    25. KENDALL, R. W., DUNCAN, C.P., SMITH, J.A., NGUI-YEN, J.H.: Persistence of Bacteria on Antibiotic Loaded Acrylic Depots. A Reason for Caution. Clin. Orthop., 329: 273-280, 1996. Go to original source... Go to PubMed...
    26. KOLÁŘ, M., LÁTAL, T., ČERMÁK, P.: Klinicko-mikrobiologické podklady racionální antibiotické léčby. Praha, Trios, 2002.
    27. KRBEC, M., ČECH, O., DŽUPA, V., PACOVSKÝ, V., KLÉZL, Z.: Infekční komplikace TEP kyčelního kloubu. Acta Chir. orthop. Traum. čech., 71: 179-188, 2004.
    28. LANDOR, I., VAVŘÍK, P., JAHODA, D.: Obecné principy léčby infekce kloubních náhrad. Acta Chir. orthop. Traum. čech., 72: 183-190, 2005.
    29. LIDGREN, L., KNUTSON, K., ROBERTSSON, O.: Annual report from the swedish knee arthroplasty register [online]. Lund, SKAR, Nov 1st, 2005 [cit. 2005-12-06]. Dostupný z WWW: http://www.ort.lu.se/knee/.
    30. LIDWELL, O. M.: Air, antibiotics and sepsis in replacement joints. J. Hosp. Infect., 11 (Suppl. C): 18-40, 1988. Go to original source... Go to PubMed...
    31. LISTER, J.: On the antiseptic principle in surgery. Lancet, 2: 353, 1867. Go to original source...
    32. MAATHUIS, P. G., NEUT, D., BUSSCHER, H. J., VAN DER MEI, H. C., VAN HORN, J. R.: Perioperative contamination in primary total hip arthroplasty. Clin. Orthop., 433: 136-139, 2005. Go to original source... Go to PubMed...
    33. MALCHAU, H., HERBERTS, P., EISLER, T., GARELLICK, G., SODERMAN, P.: The swedish total hip replacement register. J. Bone Jt Surg., 84-A (Suppl. 2): 2-20, 2002. Go to original source... Go to PubMed...
    34. McPHERSON, E. J., WOODSON, C., HOLTOM, P., ROIDIS, N., SHUFELT, C., PATZAKIS, M.: Periprosthetic total hip infection: outcomes using a staging system. Clin. Orthop., 403: 8-15, 2002. Go to original source...
    35. MENON, T. J., THJELLESEN, D., WROBLEWSKI, B. M.: Charnley low-friction arthroplasty in diabetic patients. J. Bone Jt Surg., 65: 580-581, 1983. Go to original source... Go to PubMed...
    36. MENON, T. J., WROBLEWSKI, B. M.: Charnley low-friction arthroplasty in patients with psoriasis. Clin. Orthop., 176: 127-128, 1983. Go to original source...
    37. MINNEMA, B., VEARNCOMBE, M., AUGUSTIN, A., GOLLISH, J., SIMOR, A. E.: Risk factors for surgical-site infection following primary total knee arthroplasty. Infect. Control Hosp. Epidemiol., 25: 477-480, 2004. Go to original source... Go to PubMed...
    38. NEHRER, S., THALHAMMER, F., SCHWAMEIS, E., BREYER, S., KOTZ, R.: Teicoplanin in the prevention of infection in total hip replacement. Arch. orthop. traum. Surg., 118: 32-36, 1998. Go to original source... Go to PubMed...
    39. NICHOLS, R. L.: Current Strategies for Prevention of Surgical Site Infections. Curr. Infect. Dis. Rep., 6: 426-434, 2004. Go to original source... Go to PubMed...
    40. OSTRANDER, R. V., BOTTE, M. J., BRAGE, M. E.: Efficacy of surgical preparation solutions in foot and ankle surgery. J. Bone Jt Surg., 87-A: 980-985, 2005. Go to original source... Go to PubMed...
    41. OSTRANDER, R. V., BRAGE, M. E., BOTTE, M. J.: Bacterial skin contamination after surgical preparation in foot and ankle surgery. Clin. Orthop., 406: 246-252, 2003. Go to original source...
    42. PARVIZI, J., WICKSTROM, E., ZEIGER, A. R., ADAMS, C. S., SHAPIRO, I. M., PURTILL, J. J., SHARKEY, P. F., HOZACK, W. J. et al.: Titanium surface with biologic activity against infection. Clin. Orthop., 429: 33-38, 2004. Go to original source... Go to PubMed...
    43. SALVATI, E. A., GONZALEZ DELLA VALLE, A., MASRI, B. A., DUNCAN, C. P.: The infected total hip arthroplasty. Instr. Course Lect. (AAOS), 52: 223-245, 2003.
    44. SMABREKKE, A., ESPEHAUG, B., HAVELIN, L. I., FURNES, O.: Operating time and survival of primary total hip replacements: an analysis of 31,745 primary cemented and uncemented total hip replacements from local hospitals reported to the Norwegian Arthroplasty Register 1987-2001. Acta orthop. scand., 75: 524-532, 2004. Go to original source... Go to PubMed...
    45. SOUTHWOOD, R. T., RICE, J. L., McDONALD, P. J., HAKENDORF, P. H., ROZENBILDS, M. A.: Infection in experimental arthroplasties. Clin. Orthop., 224: 33-36, 1987. Go to original source...
    46. SURIN, V. V., SUNDHOLM, K., BACKMAN, L.: Infection after total hip replacement. With special reference to a discharge from the wound. J. Bone Jt Surg., 65-B: 412-418, 1983. Go to original source... Go to PubMed...
    47. VAVŘÍK, P., LANDOR I. JAHODA, D.: Zkušenosti s léčbou infekce aloplastiky kolenního kloubu. Acta Chir. orthop. Traum. čech., 67: 121-127, 2000.
    48. von EIFF, C., JANSEN, B., KOHNEN, W., BECKER, K.: Infections associated with medical devices: pathogenesis, management and prophylaxis. Drugs, 65: 179-214, 2005. Go to original source... Go to PubMed...
    49. WEINRAUCH, P.: Diagnostic value of routine drain tip culture in primary joint arthroplasty. ANZ J. Surg., 75: 887-888, 2005. Go to original source... Go to PubMed...
    50. YOSHIMURA, Y., KUBO, S., HIROHASHI, K., OGAWA, M., MORIMOTO, K., SHIRATA, K., KINOSHITA, H.: Plastic iodophor drape during liver surgery operative use of the iodophor-impregnated adhesive drape to prevent wound infection during high risk surgery. World J. Surg., 27: 685-688, 2003. Go to original source... Go to PubMed...

    Return to the content