How to minimize infection and thereby maximize patient outcomes in total joint arthroplasty

A multicenter approach

Kenneth David Illingworth, William Mihalko, Javad Parvizi, Thomas Sculco, Benjamin McArthur, Youssef El Bitar, Khaled J. Saleh

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Total joint arthroplasty is one of the most common and most successful orthopaedic procedures. Infection after total joint arthroplasty is a devastating problem that expends patient, surgeon, and hospital resources, and it substantially decreases the chances of a successful patient outcome. Postoperative infection affects approximately 1% to 7% of all total joint arthroplasties, at a cost of approximately $50,000 per infection. Decreasing postoperative periprosthetic joint infection is of the utmost importance for the total joint arthroplasty surgeon. Preoperative, perioperative, intraoperative, and postoperative measures to minimize infection and optimize patient outcomes in total joint arthroplasty are discussed. Preoperative measures include management of patients colonized by Staphylococcus aureus, nutritional optimization, and management of medical comorbidities. Perioperative measures include skin preparation and prophylactic antibiotics. Intraoperative measures include body exhaust suits, laminar flow, ultraviolet light, operating-room traffic control, surgical suite enclosures, anesthesia-related considerations, and antibiotic-loaded bone cement. Postoperative measures include continued antibiotic prophylaxis, blood transfusions, hematoma formation and wound drainage, duration of hospital stay, and antibiotic prophylaxis for future invasive procedures.

Original languageEnglish (US)
JournalJournal of Bone and Joint Surgery - Series A
Volume95
Issue number8
DOIs
StatePublished - Apr 17 2013

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Arthroplasty
Joints
Infection
Antibiotic Prophylaxis
Orthopedic Procedures
Body Weights and Measures
Anti-Bacterial Agents
Bone Cements
Operating Rooms
Ultraviolet Rays
Blood Transfusion
Hematoma
Staphylococcus aureus
Comorbidity
Drainage
Length of Stay
Anesthesia
Costs and Cost Analysis
Skin
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

How to minimize infection and thereby maximize patient outcomes in total joint arthroplasty : A multicenter approach. / Illingworth, Kenneth David; Mihalko, William; Parvizi, Javad; Sculco, Thomas; McArthur, Benjamin; El Bitar, Youssef; Saleh, Khaled J.

In: Journal of Bone and Joint Surgery - Series A, Vol. 95, No. 8, 17.04.2013.

Research output: Contribution to journalArticle

Illingworth, Kenneth David ; Mihalko, William ; Parvizi, Javad ; Sculco, Thomas ; McArthur, Benjamin ; El Bitar, Youssef ; Saleh, Khaled J. / How to minimize infection and thereby maximize patient outcomes in total joint arthroplasty : A multicenter approach. In: Journal of Bone and Joint Surgery - Series A. 2013 ; Vol. 95, No. 8.
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