Infection in hip prostheses
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Why does infection occur in hip prostheses?
Hip prosthesis infection is a probable risk, although of low probability, it occurs due to the survival of becteria or fungi within the plastic or metal implant that provides them with the appropriate “biofilm” to live.
To understand what is happening, it is necessary to highlight that human beings are surrounded by microorganisms that we keep under control thanks to the immune system, from food to the skin is contaminated with fungi, bacteria and parasites that can be present during surgery.
Although hip replacement surgery with prosthesis implantation is one of the most successful in orthopedic medicine, it does not mean that it does not cause risks, among these dangers is the development of an infection caused by common bacteria or fungi.
Once the microorganisms are lodged in the prosthesis it is a more complex job for the immune system to fight it, over time the proliferation of bacteria becomes an infection that can cause pain, instability and even misalignment of the joint.
Types of hip replacement infection
Hip prosthetic infection is classified according to the type of microorganism that has infected it, a specialized clinical analysis with culture is required to identify which bacteria or fungus is causing the damage to the joint.
For doctors, it is essential to know the type of infection to determine the treatment, since microorganisms are resistant beings that require specific action to eradicate it.
Symptoms and signs of infection in hip prostheses
There are two times when a prosthetic hip infection can occur, the first occurs in a maximum of three months after surgery, while the second and more common, occurs in later periods that makes it difficult to identify the problem.
Symptoms of an early prosthetic infection:
Within 1 to 3 months after surgery, the patient may demonstrate classic signs of infection such as high fever, joint pain, swelling, drainage of purulent or foul-smelling fluid through the wound.
These are clear symptoms that warn of an infection thanks to the fact that the body has not healed the skin in its entirety. In these cases, the treatment is faster and more effective.
Symptoms of a late prosthetic infection.
These infections occur more than three months after surgery, once the wound is healed and the symptoms are confusing. The main sign is pain, which can be related to any other condition.
The proliferation of bacteria is created on the prosthesis, creating a strengthened habitat for their survival that protects them from treatments, which makes this case the most complex to heal.
In conclusion, the symptoms are:
- High fever.
- Weakness in the joint, that is, difficulty in mobilizing it.
- Pain.
- Inflammation and/or redness of the skin, in rare cases.
How is a hip prosthesis infection diagnosed?
The diagnostic process of an infection in the hip prosthesis is complex, requiring the intervention of various professionals to help distinguish the type of microorganism and thus the best treatment.
An orthopedic doctor, microbiologist and radiologist are required so that, with joint work, they can determine the best way to heal the joint.
Among the options offered for diagnosis are:
- Blood tests: As a starting point, alterations in some levels of the blood can warn the doctor of an infection, of course it is not a definitive examination but provides guidance on which direction to continue.
- Imaging tests: MRIs or CT scans to look at the internal condition of the infected joint. In most cases, the level of infection is shown.
- Joint sample culture: A sample is removed from the affected joint, a procedure that must be performed by a professional so that the sample can be cultured in a laboratory. Culture allows bacteria to proliferate and identify themselves in order to offer a better approach to the problem.
Treatment for hip replacement infection.
To cure a hip infection, it is necessary to mix two currents of treatments, pharmacological and surgical.
At first, the doctor will focus on minimizing the patient’s pain through analgesic medications and antibiotics that weaken the infection, while the surgical intervention is organized.
Then, a joint debridement surgery is carried out, which consists of accessing the infected area of the hip and removing all the infected tissue, performing a deep cleaning of the area in order to reduce the force of the infection.
Depending on the case of each patient, the doctor can choose to clean the prosthesis, change it for another or remove it completely, leaving the joint without metal parts where bacteria live.
Consult with a trusted orthopedic doctor.
In Panama you can count on Dr. José Felix Castillo who is a specialist in hip and knee.
How to prevent an infection in hip replacements?
To prevent a prosthesis infection, it is necessary to apply measures before, during and after the operation, working together the doctor and patient can minimize the risk of infection.
First, eliminate those medications that weaken the immune system and provide a strategy that strengthens it. During the process, the orthopedic doctor can use prostheses and antibiotic cement that provides effective protection against possible infections.
Last but not least, you should act with a procedure after surgery, manage wound healing by following sanitary practices, as well as reinforce the process with the intake of antibiotics.
Do you need help with your hip replacement?
Dr. José Felix Castillo is an orthopedic doctor specializing in hip and knee.
Schedule an appointment.