Prevention of prosthetic joint and other types of orthopedic hardware infection
- Elie Berbari, MD, FIDSA
Elie Berbari, MD, FIDSA
- Professor of Medicine
- Mayo Clinic College of Medicine
- Larry M Baddour, MD, FIDSA
Larry M Baddour, MD, FIDSA
- Professor of Medicine
- Mayo Clinic College of Medicine
Management of orthopedic hardware infection (including prosthetic joint infection as well as other types of orthopedic hardware) requires multiple surgical interventions and prolonged antibiotic therapy; treatment failure is common. Given the challenges associated with treating orthopedic hardware infection, prevention of infection is clearly desirable.
Most literature regarding prevention of orthopedic hardware infection is derived from prosthetic joint infection since this is the most common type of orthopedic hardware placement. Data regarding other types of orthopedic hardware are limited; however, in general, similar principles of prevention may be applied.
Issues relating to the prevention of orthopedic hardware infection will be reviewed here; guidelines addressing these issues include the National Surgical Infection Prevention Project [1,2], guidelines from the Medical Letter (table 1) , guidelines from the American Society of Health-System Pharmacists , and an Advisory Statement from the American Academy of Orthopaedic Surgeons .
The epidemiology, clinical manifestations, diagnosis, and treatment of orthopedic hardware infections are discussed separately. (See "Prosthetic joint infection: Epidemiology, clinical manifestations, and diagnosis" and "Prosthetic joint infection: Treatment".)
PRIOR TO HARDWARE REPLACEMENT
S. aureus decolonization — Issues related to Staphylococcus aureus decolonization prior to orthopedic surgery are discussed further separately. (See "Overview of control measures for prevention of surgical site infection in adults", section on 'S. aureus decolonization'.)
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- PRIOR TO HARDWARE REPLACEMENT
- S. aureus decolonization
- Other preventive measures
- DURING HARDWARE REPLACEMENT
- Antimicrobial prophylaxis
- Local antibiotic delivery
- FOLLOWING HARDWARE REPLACEMENT
- Dental procedures
- Urologic procedures
- Gastrointestinal procedures
- SOCIETY GUIDELINE LINKS
- SUMMARY AND RECOMMENDATIONS