Methicillin-resistant Infection After Hip and Knee Replacement: Reason to Change Practice?

Infection after a primary total-joint replacement can be devastating. If the infecting organism is methicillin resistant, the chance of successful eradication of the infection is considerably decreased. What is more concerning is that these organisms are becoming increasingly common in periprosthetic joint infection. We have reviewed the literature and have outlined the effectiveness of single- and two-stage treatment regimens for this difficult problem. We have also looked at the screening and decolonisation methods that have been implemented in an attempt to decrease the risk of surgical site infections. Lastly, we outline our recommendations on how we should tackle this emerging and difficult problem that is affecting the orthopaedic world.

中文摘要全關節置換術後的感染之破壞性極大。若果感染的細菌為抗甲氧西林時，成功根絕感染的機會是相當之低，更使人擔心的是這類型的細菌在關節假體周圍的感染愈來愈普遍。對於這種難題，我們重新探討文獻並概述I和II期翻修術的治療方案，也仔細檢查篩選法和去细菌定植法的實施，在減少手術處感染風險之效用。最後，我們概述一些建議，應該怎樣去處理這些正在影響矯型骨科界新出現的難題。