{"title":"[Septic revision arthroplasty: how to confirm diagnosis, plan surgery and manage follow-up treatment].","authors":"Stephanie Kirschbaum, Carsten Perka","doi":"10.1007/s00132-021-04176-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Septic revision arthroplasty represents an interdisciplinary challenge in terms of diagnosis as well as surgical and follow-up treatment.</p><p><strong>Diagnosis: </strong>The implementation of a standardized diagnostic algorithm including anamnesis, clinic, imaging, blood sampling and joint aspiration is essential. Depending on the duration of the symptoms acute (< 3 weeks) and chronic (> 3 weeks) infections are distinguished.</p><p><strong>Therapy: </strong>While acute infections show an immature biofilm and can usually be addressed surgically via debridement and changing the mobile parts, chronic infections almost always require a complete change of the implant. This can be done in one or two stages, depending on the general condition of the patient, the pathogen, its resistances as well as the wound conditions. The surgical revision is always followed by a resistance-based antibiotic treatment.</p>","PeriodicalId":54669,"journal":{"name":"Orthopade","volume":"50 12","pages":"995-1003"},"PeriodicalIF":0.0000,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Orthopade","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00132-021-04176-8","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/10/15 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Septic revision arthroplasty represents an interdisciplinary challenge in terms of diagnosis as well as surgical and follow-up treatment.
Diagnosis: The implementation of a standardized diagnostic algorithm including anamnesis, clinic, imaging, blood sampling and joint aspiration is essential. Depending on the duration of the symptoms acute (< 3 weeks) and chronic (> 3 weeks) infections are distinguished.
Therapy: While acute infections show an immature biofilm and can usually be addressed surgically via debridement and changing the mobile parts, chronic infections almost always require a complete change of the implant. This can be done in one or two stages, depending on the general condition of the patient, the pathogen, its resistances as well as the wound conditions. The surgical revision is always followed by a resistance-based antibiotic treatment.
期刊介绍：
Der Orthopäde is an internationally recognized journal dealing with all aspects of orthopaedics and its neighboring areas. The journal serves both the scientific exchange and the continuing education of orthopaedists.
Freely submitted original papers allow the presentation of important clinical studies and serve scientific exchange.
Comprehensive reviews on a specific topical issue focus on providing evidenced based information on diagnostics and therapy.
Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.
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