Infected Prosthesis

From Anvita Health Wiki

Contents 1 Clinical-manifestations 2 Laboratory 3 Diagnostic-procedures 4 Radiology 5 Management 6 More General Terms 7 Additional Terms 8 References

Clinical-manifestations

• previously painless prosthetic joint becomes painful
• loosening of prosthesis

Laboratory

• joint aspiration for culture
• erythrocyte sedimentation rate (ESR) may be elevated
• C-reactive protein ( CRP) may be elevated
• open biopsy of bone

• neutrophils plus positive cultures indicate infection

Diagnostic-procedures

• arthrography

Radiology

• X-ray may show loosening or migration of cemented prosthesis
• indium 111-labeled autologous leukocyte scan

Management

• surgery:

• in most cases removal of the prosthesis
• antibiotic-loaded cement spacers may be used with prosthesis replacement

• antibiotics

• parenteral antibiotics for 6 weeks
• synergistic effect of rifampin

• prophylactic antibiotics ( cefazolin or vancomycin) before high-risk procedures in patients with prosthetic joints [1]

More General Terms

• infection (infectious disease)

Additional Terms

• prosthesis

References

- Medical Knowledge Self Assessment Program (MKSAP) 11, 14, American College of Physicians, Philadelphia 1998, 2006 infected prosthesis