Management of Prosthetic Infection According to Organism

Abstract

Since the advent of prosthetic joint replacement surgery, patients with arthritis have had significant improvement in pain-relief, mobility and quality of life. Approximately 90,000 Australians undergo joint replacement surgery each year [1]. With an ageing population, this number will increase (figure 1). Similar data from USA predicts that by 2030 the number of procedures per year will increase to 4.05 million [2]. Despite the overall success of this surgery, infection of the prosthesis remains a devastating complication [3]. Of concern, the incidence of prosthetic joint infection is increasing, in proportion to the number of procedures being performed [4]. Significant patient morbidity is associated with prosthetic joint infections, including the need for further operative procedures, long-term antibiotic therapy with associated toxicity, and prolonged hospitalisation [3]. In addition, the cost to the health system is substantial. The cost of treating infection is 3-5 times the cost of primary arthroplasty [5, 6]. In Australia, the annual additional expenditure incurred as a result of this devastating complication is estimated at AUD $90 million per year [6]. In the United States, the annual cost of treatment of prosthetic joint infection is projected to exceed US$1.6 billion dollars by 2020[7].