Joint Infection Treatment

Though it is rare for patients to develop an infection after a joint replacement, joint infections are very serious when they do occur and require prompt and thorough treatment. Patients with certain conditions and comorbidities have a higher risk of developing joint infections even if the surgery goes perfectly. It is important to be able to spot the signs of infection and seek treatment as soon as possible.

Joint infections often require revision joint replacement, so it is important to choose a surgeon with extensive experience in both treating infections and revision procedures. Dr. Warth is a board-certified orthopedic surgeon who completed fellowship training at the Hospital for Special Surgery, a leading facility for joint replacement surgery. He frequently handles complex cases like joint infections and revision hip and knee replacements, and colleagues often refer to these types of cases to him. Dr. Warth emphasizes that this is one of the most rewarding aspects of his practice, to be able to take excellent care of patients with complex problems that many surgeons feel uncomfortable treating.

Preventing Joint Infections

Dr. Warth takes several precautions to minimize the risk of joint infections in his own practice, and his individual infection rates are very low. The vast majority of the joint infection cases Dr. Warth treats are patients referred from other practices and surgeons. However, there is always a very small risk of infection, even in the hands of the best surgeons.

We have protocols in place before, during, and after surgery to minimize risks, including:

Having patients take antibiotics both before and after surgery
Efficient surgical procedures to minimize the time spent in the operating room
Strict sterilization techniques and protocols for all operating instruments and surgical environments
Having patients take antibiotics for any major dental work done after the joint replacement, including tooth extraction, root canals, etc.

The above protocols can greatly reduce the risk of infection, but it can never be 100% eliminated because there are outside factors that we cannot control.

Causes & Signs of a Joint Infection

When we look at the overall population of joint replacement patients, joint infections are fairly rare. Sometimes, infections develop years after the initial joint replacement due to chronic infections unrelated to the joint replacement procedure.

On average, less than 2% of joint replacement patients will develop an infection. However, the risk of infection is 3-5 times higher for patients with certain comorbidities, including obesity, diabetes, and smoking. These conditions can affect wound healing, which increases the likelihood of an infection.

It is important to know how to spot the signs of infection. If you experience any of the following symptoms, you should seek help from a medical professional:

Increased warmth, redness, or swelling around the joint
Wound drainage
Feeling ill, including fever, chills, and night sweats
Increased fatigue
Increased pain and stiffness when the joint was previously functioning well

Treating Joint Infections

Treatment for joint infections can vary depending on the type and cause of infection. If it is a minor infection contained to the skin wound, extensive surgery may not be needed if treated early on. However, if the infection is present in the joint, the original joint replacement usually must be removed and replaced. This treatment is typically done in a staged approach.

During the first stage of treatment, Dr. Warth will remove the joint implants, wash out the joint and surrounding tissues, and place a temporary implant. Following that initial procedure, patients are typically on IV antibiotics for at least 6 weeks. However, Dr. Warth tailors antibiotic recommendations to the patient’s needs following research-based guidance. Ultimately, the goal is to clear the infection so that new, permanent implants can be put in place. The hospital has an infectious disease specialist on-site who guides the treatment of the infection after surgery is performed.

When it is safe to do so, Dr. Warth will perform a revision joint replacement by removing the temporary implants and replacing them with permanent revision implants. Long-term results and recovery times are highly variable for infection cases. Dr. Warth addresses each patient on an individual basis to discuss protocols and reasonable expectations based on the patient’s needs and the complexity of the problem. The ultimate goal is to ensure that the patient is able to live their life at the highest quality possible after recovering from the infection.