Infection in Orthopaedics

J Orthop Trauma. 2015 Dec:29 Suppl 12:S19-23. doi: 10.1097/BOT.0000000000000461.

Abstract

Infection in orthopaedic trauma patients is a common problem associated with significant financial and psychosocial costs, and increased morbidity. This review outlines technologies to diagnose and prevent orthopaedic infection, examines implant-related infection and its management, and discusses the treatment of post-traumatic osteomyelitis. The gold standard for diagnosing infection has a number of disadvantages, and thus new technologies to diagnose infection are being explored, including multilocus polymerase chain reaction with electrospray ionization-mass spectrometry and optical imaging. Numerous strategies have been employed to prevent orthopaedic infection, including use of antibiotic-impregnated implant coatings and cement; however, further research is required to optimize these technologies. Biofilm formation on orthopaedic implants is attributed to the glycocalyx-mediated surface mode of bacterial growth and is usually treated through a secondary surgery involving irrigation, debridement and the appropriate use of antibiotics, or complete removal of the infected implant. Research into the treatment of post-traumatic osteomyelitis has focused on developing an optimal local antibiotic delivery vehicle, such as antibiotic-impregnated polymethylmethacrylate (PMMA) cement beads or bioabsorbable bone substitute (BBS) delivery systems. As these new technologies to diagnose, prevent and treat orthopaedic infection advance, the incidence of infection will decrease and patient care will be optimized.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Antibiotic Prophylaxis / methods*
  • Evidence-Based Medicine
  • Humans
  • Joint Prosthesis / adverse effects*
  • Joint Prosthesis / microbiology
  • Osteomyelitis / diagnosis
  • Osteomyelitis / etiology
  • Osteomyelitis / prevention & control*
  • Prosthesis-Related Infections / diagnosis
  • Prosthesis-Related Infections / etiology*
  • Prosthesis-Related Infections / prevention & control*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents