3 - bone&joint infection

Question 1

what are basic principles for surgical bone & joint infections?

Answer 1

1. know bug
2. operate if pus
3. target antibiotics for suitable time

Question 2

what are 5 clinically relevant infections?

Answer 2

1. acute osteomyelitis
2. chronic osteomyelitis
3. septic arthritis
4. soft tissue infections
5. infected arthroplasty

Question 3

who is most likely to get acute osteomyelitis? (by inoculation or haematogenous)

Answer 3

• post-traumatic = caused by inoculation (infected from outside)
• haematogenous (originating in blood) cause like children or immunosuppressed

Question 4

what are 2 ways of spread to cause septic arthritis?

Answer 4

1. inoculation = introduction of pathogens directly into the joint space through trauma, surgery, or joint injections
2. haematogenous = spread from within body - blood or bone (metaphyseal spread)

*septic arthritis = bugs in joint

Question 5

what is examples of soft tissue infections?

Answer 5

necrotising fasciitis (gas forming organism) and cellulitis

• needs operation and antibiotics (best guess staph & strep)

Question 6

what is infected arthroplasty?

Answer 6

→infected joint replacement. deep infection. hip replacement that never had no pain.

• sinus tract near joint infection

Question 7

what is treatment of infected arthroplasty?

Answer 7

remove everything! (infected prosthesis & hardware) - leave for 3 months with antibiotics then try again with new joint

Question 8

what preventative measures for infected arfthroplasty?

Answer 8

clean theatre, local & systemic antibiotics, short operation as possible