Infections in Total Joint Replacement Surgery

It is possible by now that you have heard your doctor or nurses talk about avoiding infection when it comes to total joint replacement surgery. This is because infection is one of the most severe complications a patient might face. While there is a relatively low incidence of infection occurring, all surgeries have some element of risk. It is still vitally important to take active steps to avoid infection and to carefully listen to, and abide by, your medical team’s advice and instructions at all times. They certainly do have your best interest at heart!

Why does infection occur?

When it comes to total joint replacement, simply put, a patient will have a foreign body (prosthesis) permanently placed in their body. Instead of being made from human tissue, which can fight and draw infection away, the prosthesis is made from metal or plastic. Should the tissue surrounding the prosthesis get infected, the body will battle to get rid of the germs fast enough, and there is a greater likelihood of the infection lingering and getting worse, eventually establishing itself. Once established, it is imperative that it gets treated straight away. It is ideal to try and avoid this happening in the first place or to catch it as soon as possible and start treatment before the infection establishes itself.

DID YOU KNOW? The infection rate was as high as 14% when John Charnley introduced the prosthesis in 1960. Since then it has gradually declined to between 1% and 4% over the life of the prosthesis.¹

When does infection occur?

Infection can occur in the hospital, when you return home, and even months or years later. It is important to remember that any infection in the body can lead to infection in the area of your new joint. In the case of total joint replacement surgery, the age-old adage rings true, “Prevention is better than cure.”

How can you prepare for surgery with the prevention of infections in mind?

• Make sure you don’t have any open wounds before surgery. Should anything occur just before surgery, make sure you bring this to the immediate attention of your medical team.
• Take any medicines (possibly antibiotics) as prescribed, in the lead up to your surgery.
• You will be provided with antiseptic body wash to shower/ bath in daily, leading up to your surgery. Follow the directions of your medical team.
• Do not shave the operation site at home. For the ladies, don’t shave your legs for at least three days before your operation, to prevent micro-cuts which could open you to the risk of infection.
• Maintain a healthy weight.
• If you are a smoker, if possible, stop smoking.
• Ensure your blood sugar is under control, in particular, if you have diabetes.

Top Tip: Before your total joint replacement surgery, look to resolving any skin-related conditions that could pose a risk of introducing infection into the body. This includes planning a visit to the dentist before your surgery to check that your mouth is clean and infection-free.

What are the signs of infection after hip or knee surgery?

There are a few ‘warning signs’ that you should look out for when it comes to identifying infection in your new joint. (Something you would want to determine as soon as possible, in order to treat the infection whilst it is still minor.) Report any unusual symptoms to your medical team immediately.

These may include the following symptoms:

• Wound: You can expect some bruising and swelling around the wound area. However increased redness, tenderness, heat or swelling at the site of the incision should be monitored and reported immediately. Also, watch how the incision wound is draining – report any bleeding and/or a wet dressing.
• Pain: Whilst some discomfort can be expected after surgery if you experience increasing or excessive pain, while at rest as well as during activity, please do not ignore it.
• Fever: A fever (of over 37.8 degrees) that will not break, as well as chills and possible night sweats, should be reported.

How are infections treated?

The type of treatment for infections in the joint can vary based on the severity of the infection. Mild infections are treated with a course of antibiotics. More severe and deeper infections in the tissue may result in additional surgery or even the need to remove the prosthesis. Any course of treatment will be determined alongside your medical team and discussed with you in-depth.

Should you have any additional questions about your Joint Replacement Surgery, and the topic of infections, or wish to book an in-person or virtual consult, get in touch with our team today.

 

REFERENCES

 1. Prevent infection of joint replacement