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Results of periprosthetic hip and knee infections caused by resistant bacteria.
Clinical Orthopaedics and related Research 2002 November
Seventy patients with deep periprosthetic hip or knee infections were treated between May 1997 and March 2001. Thirty-five patients had periprosthetic infections of their total hip arthroplasties and 35 patients had periprosthetic infections of their total knee arthroplasties. The patients were subdivided into two subgroups: patients who had infections with Staphylococcal bacterial strains that were sensitive to methicillin and patients who had infections with bacteria that were resistant to methicillin (methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis). Treatment was considered successful if the patient was able to retain his or her hip or knee prosthesis either as a result of irrigation and debridement procedures alone or after excision of the infected total hip or knee prosthesis followed by successful reimplantation. Treatment was considered a failure if the patient eventually required arthrodesis, amputation, or was left with a permanent excision arthroplasty. Hip replacements that were infected with antibiotic-sensitive bacteria were treated successfully in 81% of cases. In contrast, hip replacements infected with resistant organisms were treated successfully in only 48% of cases. Similarly, knee replacements infected with sensitive organisms had a success rate of 89%, compared with only 18% of the total knee replacements that were infected with resistant bacterial strains.
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