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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 2, 249-256.
doi: 10.1302/0301-620X.87B2.15618  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Treatment of infected retained implants

R. Trebse, MD, Orthopaedic Surgeon; V. Pisot, MD, Orthopaedic Surgeon; and A. Trampuz, MD, Infectious Diseases Specialist

Orthopaedic Hospital Valdoltra, Jadranska 31, SI-6280 Ankaran, Slovenia.
Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, Minnesota 55905, USA.

Correspondence should be sent to Dr A. Trampuz at the Division of Infectious Diseases, University Hospital Basel, Petersgnaben 4, CH-4031 Basel, Switzerland; e-mail: atrampuz{at}uhbs.ch

We have prospectively studied the outcome of infections associated with implants which were retained and treated using a standardised antimicrobial protocol. Over a period of four years, we studied 24 consecutive patients who had symptoms of infection for less than one year, a stable implant, no sinus tract and a known pathogen which was susceptible to recommended antimicrobial agents. The infections involved hip prostheses (14), knee prostheses (5), an internal fixation device (4), and an ankle prosthesis (1).

Twenty patients had a successful outcome at a median follow-up of 3.7 years (1.8 to 4.7); four had failure of the implant after a median follow-up of 1.2 years (0.3 to 2.5). The probability of survival without failure of treatment was 96% at one year (95% confidence interval (CI) 88 to 100), 92% at two years (95% CI 80 to 100) and 86% at three years (95% CI 72 to 100).

Patients with a short-term infection but with a stable implant, no sinus tract and a known pathogen may be successfully treated by retention of the implant and the use of a standardised regimen of antimicrobial treatment.




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Immune status of patients and diagnostic difficulties in infected implants
Anil Agarwal M.S. (Ortho.), et al.
J Bone Joint Surg Br Online, 19 May 2005 [Full text]

(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General