Infection Following Total Joint Replacement

Louis G. Mercuri


Ever since orthopedic total joint replacement (TJR) was introduced by Sir John Charnley [1], orthopedic joint replacement has gained popularity given the considerable improvement in biocompatibility, functionality, and durability of these devices [2, 3]. Many of these alloplastic joints can function properly for decades [4-6]. However, one of the potential drawbacks to this technological and clinical advancement in the management of end-stage joint disease is the susceptibility of these devices to infection. Management of these infections involves elimination of the infection and returning the joint to function. In order to achieve these goals, early diagnosis and a rational management plan that includes surgical intervention, combined with appropriate antibiotic therapy, are essential [7, 8].

The Medicare 5% national sample administrative database documents a 1.63% and 1.55% risk of infection within the first 2 years following primary total hip (THA) and knee arthroplasty (TKA), with an additional risk between 2 and 10 years of 0.59% and 0.46%, respectively [9, 10]. Further studies have suggested that both the incidence and prevalence of periprosthetic joint infection (PJI) is increasing with time, with the overall infection burden expected to rise to >6% in the coming years [11].

In a retrospective survey of 2476 TMJ TJR cases involving 3368 joints, there were 51 (1.51%) reported cases of infection in the postoperative period which ranged from 2 weeks to 12 years [12]. Despite these statistics that demonstrate postoperative TMJ TJR infection as relatively uncommon, the clinical, psychological,

L.G. Mercuri, DDS, MS

Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

TMJ Concepts, Ventura, CA, USA e-mail: This email address is being protected from spam bots, you need Javascript enabled to view it

© Springer International Publishing AG 2017

G.F. Bouloux (ed.), Complications of Temporomandibular Joint Surgery, DOI 10.1007/978-3-319-51241-9_10

and economic consequences of this complication can be substantial. Therefore, the development of management algorithms based on early diagnostic testing has been the subject of continued exploration in the literature [13].

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