Septic Endoprosthetics- Orthopedics

Septic endoprosthetic infection is a rare complication associated with joint replacement surgery caused by bacterial infection of the implant and subsequent damage to the surrounding tissue. While the incidence is rare, septic endoprosthetic infection is regarded as the most severe complication of joint replacement that is challenging to manage, potentially leading to sepsis, morbidity, or mortality. 

Bacteria may reach the joint by two possible pathways:

Direct invasion: The usual route of early infection in the first 3 months after joint replacement, direct invasion can occur in different ways. A lack of sterility during surgery can lead to an infection caused by a contaminated prosthesis. Improper wound care in the post-operative period leading to an infection that - left untreated - extends to reach the joint is another possible pathway. In such a case, infection occurs via a hollow connection (a sinus tract) from the skin on the surface to the inside of your joint.

Hematogenous spread: A late-occurring pathway of prosthetic joint infection, typically after two years of surgery, hematogenous spread occurs when bacteria infect an unrelated part of your body (Eg. the gallbladder), spread to the blood, and reach the prosthesis. Dental surgery is another possible cause of hematogenous spread with bacteria entering your bloodstream and reaching your joint. Once bacteria invade the bloodstream, there's a high likelihood of it infecting a prosthetic joint.

Staphylococcus aureus (44%) and enteric gram-negative bacilli, like E. Coli and Klebsiella (25%), are organisms commonly associated with septic endoprosthetic infections.

To learn more about Septic Endoprosthetics, please check our blog on PROSTHETIC JOINT INFECTION: TYPES, SYMPTOMS, CAUSES, & TREATMENT.

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