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Minerva Ortopedica e Traumatologica 2012 October;63(5):295-306


language: English, Italian

Hip and knee arthroplasty associated infections: a 10-year experience and literature review

Bistolfi A. 1, Cimino A. 2, Ravera L. 2, Deledda D. 2, Fucale G. 3, Vernè E. 4, Miola M. 4, Crova M. 1, 2, Massazza G. 1, 2

1 Department of Orthopedics and Traumatology AO CTO/M. Adelaide Hospital, Turin, Italy; 2 University of Turin, Turin, Italy; 3 Chemical, Clinical, and Microbiological Analyses Department, AO CTO/M. Adelaide Hospital, Turin, Italy; 4 Materials and Chemical Engineering Department, Politecnico di Torino, Turin, Italy


aim. This study has multiple aims: 1) to evaluate the incidence of Gram-positive, Gram-negative bacteria and yeasts in cases of total knee arthroplasty (TKA) and total hip arthroplasty (THA) in patients with signs of clinical infection observed at AO CTO/Maria Adelaide, Turin, Italy, from 2002 to 2010; 2) to compare the incidence of the bacteria for the infection observed at our Hospital with the bacteria described historically in the literature; 3) to find out new or different bacteria involved in the BAI compared to those described in the literature.
Methods. A retrospective evaluation of the clinical forms for all patients undergone to surgery for joint arthroplasty at AO CTO/Maria Adelaide, II Orthopedic Unit from 2002 to 2010 was performed. Inclusion criteria was the report on the surgical procedure of: 1) surgical wash of the joint after total joint arthroplasty for hematoma, swelling, flogosis and/or suspected infection; 2) TKA or THA removal and implantation of a spacer; 3) revision of total joint arthroplasty for infection or suspected infection; 4) arthrodesis; 5) amputation.
Results. Of the 248 cases studied 55 had the identification of a bacteria. In details: 14/101 total hip revisions, 17/81 total knee revisions, 6/9 hip articular washes, 14/45 knee articular washes, 4/8 knee spacers.
Conclusion. Most common involved bacteria isolated from 248 THA and TKA samples are Gram-positive cocci: particularly coagulase-negative staphylococci, S. aureus, streptococci and enterococci for hip joint arthroplasty and staphylococci, enterococci and streptococci for knee joint arthroplasty. Overall prevention and special attention to multiple resistant bacteria are the key points to reduce morbidity and costs.

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