CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ | |
Journals - Article | |
Česky / Czech version | Rozhl. Chir., 2006, roč. 85, č. 11, s. 581–585. |
Late Hematogenic
Infection of Joint Replacements and Its Prevention in Surgery Jahoda D.1, Šimša J.2, Nyč O.3, Pokorný D.1, Landor I.1, Tawa N.1, Sosna A.1 1I. ortopedická klinika l. LF UK a FN Motol, Praha, přednosta: prof. MUDr. A. Sosna, DrSc. 2I. chirurgická klinika 2. LF UK a FN Motol, Praha, přednosta: prof. MUDr. J. Hoch, CSc. 3Ústav lékařské mikrobiologie 2. LF UK a FN Motol, Praha, přednosta: MUDr. O. Nyč |
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Summary: Introduction: Late hematogenic infections of joint replacements represent a serious complication. The aim of the study is to
assess a patient group with late hematgenic infections of allografts and to propose preventive measures.
Methods: The restrospective study included patients treated for infectious complications of their joint implants in the 1st Orthopaedic
Clinic of the 1st LF UK and FN Motol during the 1991–2004 period. The study included 229 patients in total, of which 149
subjects were females and 80 were males. In 123 subjects their hip joint implant infection was managed, in 102 subjects the knee
joint endoprosthesis infection and in two subjects the shoulder joint prosthesis infection was managed. The last two subjects sufferred
from infections of their elbow joint alloplasty.
Results: Urinary infection or other procedures of urogenital tract were recorded in 37 patients (16.2%). Upper respiratory tract
infections preceding deep joint implant infections were reported in 30 subjects (13.1%). Stomatological procedures or oral cavity
disorders was diagnosed in 1 subjects (4.8%). Surgical proceudres with suspected bacteriemia was recorded in 6 subjects (2.6%).
Conclusion: Late hematological infections of bone replacements are serious complications with imminent medical and economical
consequences. The infection may be caused by a variety of conditions and medical procedures connected to bacteriemia. Provided
the risk of the joint implant infection is high (immunocompromised patients, „recent“ endoprosthesis implantation within the
last two years), prophylactic antibiotic medication is strongly recommended in all conditions with increased risk of bacteriemia.
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