Hip Pelvis.  2019 Mar;31(1):57-62. 10.5371/hp.2019.31.1.57.

Three Concurrent Periprosthetic Joint Infections: A Case Report and Literature Review

Affiliations
  • 1Department of Orthopaedic Surgery, Boston Medical Center, Boston, MA, USA. Eric.Smith@BMC.org
  • 2Department of Orthopaedic Surgery, Tufts Medical Center, Boston, MA, USA.

Abstract

Periprosthetic joint infections are a major cause of morbidity and mortality following total joint arthroplasty. Two-stage arthroplasty, with the use of an antibiotic cement spacer, is an effective means of managing periperiprosthetic joint infections. There is a lack of data relating to the management, prognosis, and clinical outcomes associated with multiple peri-prosthetic joint infections. Here, we present a case report of a patient successfully treated for three synchronic peri-prosthetic joint infections of both knees and a single hip.

Keyword

Knee replacement arthroplasty; Hip replacement arthroplasty; Periprosthetic joint infection; Two-stage arthroplasty; Concurrent periprosthetic joint infection

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Hip
Arthroplasty, Replacement, Knee
Hip
Humans
Joints*
Knee
Mortality
Prognosis

Figure

  • Fig. 1 (A) Anteroposterior (AP) and lateral views of right total knee arthroplasty at initial presentation. (B) AP and lateral views of the left total knee arthroplasty at onset of symptoms. (C) AP view of the right total hip arthroplasty at the onset of symptoms.

  • Fig. 2 Anteroposterior (AP) radiograph of the bilateral knee and AP radiograph of the right hip after component explanation with antibiotic cement spacer placement.

  • Fig. 3 One-year post-operative radiographs. (A) Anteroposterior (AP) view of bilateral revision total knee arthroplasty. (B) Lateral view of left revision total knee arthroplasty. (C) Lateral view of right revision total knee arthroplasty. (D) AP views of the right hip and right femur revealing complete revision right total hip arthroplasty stem.


Cited by  1 articles

Current and Future Burden of Periprosthetic Joint Infection from National Claim Database
Hong Seok Kim, Jung Wee Park, Sun-Young Moon, Young-Kyun Lee, Yong-Chan Ha, Kyung-Hoi Koo
J Korean Med Sci. 2020;35(49):e410.    doi: 10.3346/jkms.2020.35.e410.


Reference

1. Cui Q, Mihalko WM, Shields JS, Ries M, Saleh KJ. Antibiotic-impregnated cement spacers for the treatment of infection associated with total hip or knee arthroplasty. J Bone Joint Surg Am. 2007; 89:871–882.
Article
2. Bozic KJ, Kurtz SM, Lau E, et al. The epidemiology of revision total knee arthroplasty in the United States. Clin Orthop Relat Res. 2010; 468:45–51.
Article
3. Kurtz S, Mowat F, Ong K, Chan N, Lau E, Halpern M. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am. 2005; 87:1487–1497.
Article
4. Insall JN, Thompson FM, Brause BD. Two-stage reimplantation for the salvage of infected total knee arthroplasty. J Bone Joint Surg Am. 1983; 65:1087–1098.
Article
5. Luu A, Syed F, Raman G, et al. Two-stage arthroplasty for prosthetic joint infection: a systematic review of acute kidney injury, systemic toxicity and infection control. J Arthroplasty. 2013; 28:1490–1498.e1.
6. Murray RP, Bourne MH, Fitzgerald RH Jr. Metachronous infections in patients who have had more than one total joint arthroplasty. J Bone Joint Surg Am. 1991; 73:1469–1474.
Article
7. Parvizi J, Zmistowski B, Berbari EF, et al. New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res. 2011; 469:2992–2994.
Article
8. Osmon DR, Berbari EF, Berendt AR, et al. Executive summary: diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2013; 56:1–10.
Article
9. Berbari EF, Hanssen AD, Duffy MC, et al. Risk factors for prosthetic joint infection: case-control study. Clin Infect Dis. 1998; 27:1247–1254.
Article
10. Pulido L, Ghanem E, Joshi A, Purtill JJ, Parvizi J. Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clin Orthop Relat Res. 2008; 466:1710–1715.
Article
11. Clesham K, Hughes AJ, O'hEireamhoin S, Fleming C, Murphy CG. Second-site prosthetic joint infection in patients with multiple prosthetic joints. Eur J Orthop Surg Traumatol. 2018; 28:1369–1374.
Article
12. Luessenhop CP, Higgins LD, Brause BD, Ranawat CS. Multiple prosthetic infections after total joint arthroplasty. Risk factor analysis. J Arthroplasty. 1996; 11:862–868.
13. Jafari SM, Casper DS, Restrepo C, Zmistowski B, Parvizi J, Sharkey PF. Periprosthetic joint infection: are patients with multiple prosthetic joints at risk? J Arthroplasty. 2012; 27:877–880.
Article
14. Haverstock JP, Somerville LE, Naudie DD, Howard JL. Multiple periprosthetic joint infections: evidence for decreasing prevalence. J Arthroplasty. 2016; 31:2862–2866.
Article
15. Abblitt WP, Chan EW, Shinar AA. Risk of periprosthetic joint infection in patients with multiple arthroplasties. J Arthroplasty. 2018; 33:840–843.
Article
16. Springer BD, Lee GC, Osmon D, Haidukewych GJ, Hanssen AD, Jacofsky DJ. Systemic safety of high-dose antibiotic-loaded cement spacers after resection of an infected total knee arthroplasty. Clin Orthop Relat Res. 2004; (427):47–51.
Article
17. Hsieh PH, Chen LH, Chen CH, Lee MS, Yang WE, Shih CH. Two-stage revision hip arthroplasty for infection with a custom-made, antibiotic-loaded, cement prosthesis as an interim spacer. J Trauma. 2004; 56:1247–1252.
Article
18. Garvin KL, Hanssen AD. Infection after total hip arthroplasty. Past, present, and future. J Bone Joint Surg Am. 1995; 77:1576–1588.
Article
19. Kunutsor SK, Whitehouse MR, Lenguerrand E, Blom AW, Beswick AD. INFORM Team. Re-infection outcomes following one- and two-stage surgical revision of infected knee prosthesis: a systematic review and meta-analysis. PLoS One. 2016; 11:e0151537.
Article
20. Lentino JR. Prosthetic joint infections: bane of orthopedists, challenge for infectious disease specialists. Clin Infect Dis. 2003; 36:1157–1161.
Article
21. Zmistowski B, Karam JA, Durinka JB, Casper DS, Parvizi J. Periprosthetic joint infection increases the risk of one-year mortality. J Bone Joint Surg Am. 2013; 95:2177–2184.
Article
22. Parvizi J, Pawasarat IM, Azzam KA, Joshi A, Hansen EN, Bozic KJ. Periprosthetic joint infection: the economic impact of methicillin-resistant infections. J Arthroplasty. 2010; 25:6 Suppl. 103–107.
23. Menge TJ, Koethe JR, Jenkins CA, et al. Acute kidney injury after placement of an antibiotic-impregnated cement spacer during revision total knee arthroplasty. J Arthroplasty. 2012; 27:1221–1227. 1227.e1–1227.e2.
Article
24. Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol. 2005; 16:3365–3370.
Article
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