PREVENTION OF INFECTION IN TOTAL JOINT ARTHROPLASTY FOCUSING ON THE ROLE OF ANTIBIOTICS IN ARTHROPLASTY

Abstract

The correct diagnosis of a prosthetic joint infection (PJI) is crucial for adequate surgical treatment. The detection may be a challenge since presentation and preoperative tests are not always obvious and precise. Although a simple gold standard to confirm PJI is lacking, diagnostic criteria have been proposed. The presence of one or more of the following criteria is believed to be adequate for PJI diagnosis: acute inflammation on histopathologic examination of periprosthetic tissue, sinus tract communicating with the prosthesis, gross purulence in the joint space, or growth of the same microorganism from two or more cultures of joint aspirates or periprosthetic tissue. Several perioperative strategies are currently employed to decrease the incidence of infection, some of which are supportedby theliterature whereas others remain unproven. These strategiesrevolve around improving the host response and decreasingthe chance of bacterialcontamination in the preoperative, intraoperative,and postoperative periods. The commonly used methods to decrease the rate ofperiprosthetic joint infection will be discussed and the available literature to support their use will be reviewed.