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  • Author: Andrej Trampuz x
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Petra Izakovicova HELIOS Klinik Zerbst/Anhalt, Germany

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Olivier Borens Service of Orthopaedics and Traumatology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland

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Andrej Trampuz Charité – Universitätsmedizin Berlin, Corporate Member of Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany

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  • Periprosthetic joint infection (PJI) is a serious complication occurring in 1% to 2% of primary arthroplasties, which is associated with high morbidity and need for complex interdisciplinary treatment strategies.

  • The challenge in the management of PJI is the persistence of micro-organisms on the implant surface in the form of biofilm. Understanding this ability, the phases of biofilm formation, antimicrobial susceptibility and the limitations of host local immune response allows an individual choice of the most suitable treatment.

  • By using diagnostic methods for biofilm detection such as sonication, the sensitivity for diagnosing PJI is increasing, especially in chronic infections caused by low-virulence pathogens.

  • The use of biofilm-active antibiotics enables eradication of micro-organisms in the presence of a foreign body. The total duration of antibiotic treatment following revision surgery should not exceed 12 weeks.

Cite this article: EFORT Open Rev 2019;4:482-494. DOI: 10.1302/2058-5241.4.180092

Article Type:
Review Article
Category:
General Orthopaedics
DOI:
https://doi.org/10.1302/2058-5241.4.180092
Volume/Issue:
Volume 4: Issue 7
Open access
Sylvain Steinmetz Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

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Diane Wernly Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

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Kevin Moerenhout Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

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Andrej Trampuz Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany

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Olivier Borens Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

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  • Infection after fracture fixation is a feared complication in orthopaedic surgery leading to poor bone healing and loss of function.

  • Early detection is essential and interdisciplinary care is mandatory.

  • Eradication of infection is only possible through combined surgical and antibiotic treatment.

  • Intraoperative tissue samples must be taken and are effective for guidance of the antibiotic regimen.

  • Infection after fracture fixation is different from prosthetic joint infection (PJI) and needs a specific strategy.

  • In this review, we define infection after fracture fixation, and outline the clinical, radiological and laboratory signs of these infections, as well as a treatment algorithm for optimal patient care.

Cite this article: EFORT Open Rev 2019;4:468-475. DOI: 10.1302/2058-5241.4.180093

Article Type:
Review Article
Category:
General Orthopaedics
DOI:
https://doi.org/10.1302/2058-5241.4.180093
Volume/Issue:
Volume 4: Issue 7
Open access