Infection of a Joint Replacement

Joint replacement infections should be divided into early and late infections to understand this subject. So-called early infections, that occur in the weeks following surgery, may sometimes be cured with a surgical washout of the joint and IV antibiotics. Exactly how long this is true for is debated, some surgeons say only in the first 3 weeks, others believe in the first 8 weeks. What is known, is the longer away from surgery, the harder to cure an infection without removing the implant.

Late infections, usually occurring months or years after the joint replacement surgery, almost always require removal of the implant, placement of an "antibiotic spacer," and IV antibiotics. Patients who undergo this surgery will need at least 6 weeks of IV antibiotics, possibly more, before a new joint replacement can be put back in the joint.

Once an implant is removed for an infection, can a new one be put back in?
Yes, but not until the infection is cleared. Your orthopedic surgeon, in consult with a infectious disease specialist will determine the optimal treatment schedule, and obtain periodic blood work studies to determine when the infection is likely cured. After that time, a revision replacement (replacement of a joint replacement) may be considered.

References:

• RH Fitzgerald, Jr "Infected Total Hip Arthroplasty: Diagnosis and Treatment" J. Am. Acad. Ortho. Surg., Oct 1995; 3: 249 - 262.
• RE Windsor and JV Bono "Infected Total Knee Replacements" J. Am. Acad. Ortho. Surg., Jan 1994; 2: 44 - 53.

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