Skip to main content
SpringerLink
Log in

Current Treatment Strategies in Prosthetic Joint Infections

  • Chapter
  • First Online:
Infected Total Joint Arthroplasty

Abstract

There are many ways to approach the problem of PJI. The most ­frequently used is the two-step approach in which the first step serves for prosthetic joint removal, while in the second step, the artificial joint is reimplanted. There are, however, other options like amputation, joint fusion, implant removal, two-stage replacement, one-stage replacement, debridement and retention of implant, and permanent antibiotic suppression. Every treatment type has its indications that overlap to some extent and its advantages and disadvantages. In this chapter, these are discussed in detail for the reader to get familiar with the contemporary treatment strategies for easier implementation in own clinical praxis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. SooHoo NF, Zingmond DS, Ko CY. Comparison of reoperation rates following ankle arthrodesis and total ankle arthroplasty. J Bone Joint Surg Am. 2007;89:2143–9.

    Article  PubMed  Google Scholar 

  2. Isiklar ZU, Darouiche RO, Landon GC, Beck T. Efficacy of antibiotics alone for orthopaedic device related infections. Clin Orthop. 1996;332:184–9.

    Article  PubMed  Google Scholar 

  3. Buchholz HW, Elson RA, Engelbrecht E, Londenkamper H, Rottger J, Siegel A. Management of infection of total hip replacement. J Bone Joint Surg Br. 1981;63:342–53.

    PubMed  Google Scholar 

  4. Hunter G, Dandy D. The natural history of the patient with an infected total hip replacement. J Bone Joint Surg Br. 1977;59:293–7.

    PubMed  CAS  Google Scholar 

  5. Hanssen AD, Rand JA. Evaluation and treatment of infection at the site of a total hip or knee arthroplasty. Instr Course Lect. 1999;48:111–22.

    PubMed  CAS  Google Scholar 

  6. Rand JA. Alternatives to reimplantation for salvage of the total knee arthroplasty complicated by infection. J Bone Joint Surg. 1993;75:282–9.

    PubMed  CAS  Google Scholar 

  7. Rand JA. Sepsis following total knee arthroplasty. In: Rand JA, editor. Total knee arthroplasty. 1st ed. New York: Raven; 1993. p. 349–75.

    Google Scholar 

  8. Hintermann B, Schneiderbauer MM, Trampuž A, Widmer A. Infection rate after primary ankle replacement: a cohort study of 386 consecutive ankle replacements. #74. In: Presented at the American Academy of Orthopaedic Surgeons 74th Annual Meeting, San Diego; 14–18 February 2007.

    Google Scholar 

  9. Pring DJ, Marks L, Angel JC. Mobility after amputation for failed total knee arthroplasty. J Bone Joint Surg Br. 1988;70:770–1.

    PubMed  CAS  Google Scholar 

  10. Blom AW, Brown J, Taylor AH, Pattison G, Whitehouse S, Bannister GC. Infection after total knee arthroplasty. J Bone Joint Surg Br. 2004;86:688–91.

    Article  PubMed  CAS  Google Scholar 

  11. Leone JM, Hanssen AD. Management of infection at the site of a total knee arthroplasty. Instr Course Lect. 2006;55:449–61.

    PubMed  Google Scholar 

  12. Knutson K, Hovelius L, Lindstrand A, Lindgren L. Arthrodesis after failed knee arthroplasty: a nationwide multicenter study investigation of 91 cases. Clin Orthop. 1984;191:201–11.

    Google Scholar 

  13. Wiedel JD. Salvage of infected total knee fusion: the last option. Clin Orthop. 2002;404:139–42.

    Article  PubMed  Google Scholar 

  14. Nichols SJ, Landon GC, Tullos HS. Arthrodesis with dual plates after failed total knee arthrodesis. J Bone Joint Surg Am. 1991;73:1020–4.

    PubMed  CAS  Google Scholar 

  15. Morrey BF, editor. The elbow and its disorders. 4th ed. Philadelphia: Elsevier-Sounders; 2009.

    Google Scholar 

  16. Lew DP, Waldvogel FA. Osteomyelitis. N Engl J Med. 1997;336:999–1007.

    Article  PubMed  CAS  Google Scholar 

  17. Suda AJ, Hepperd V. Vastus lateralis muscle flap for infected hips after resection arthroplasty. J Bone Joint Surg Br. 2010;92B:1654–8.

    Google Scholar 

  18. Bourne RB, Hunter GA, Rorabeck CH, Macnab JJ. A six-year follow-up of infected total hip replacement managed by Girdlestone’s arthroplasty. J Bone Joint Surg Br. 1984;66:340–3.

    PubMed  CAS  Google Scholar 

  19. Castellanos J, Flores X, Llusa M, Chiriboga C, Navarro A. The Girdlestone pseudoarthrosis in the treatment of infected hip replacements. Int Orthop. 1998;22:178–81.

    Article  PubMed  CAS  Google Scholar 

  20. Clegg J. The results of the pseudoarthrosis after removal of an infected total hip prosthesis. J Bone Joint Surg Br. 1977;59:298–301.

    PubMed  CAS  Google Scholar 

  21. Falahee MH, Matthews LS, Kaufer H. Resection arthroplasty as a salvage procedure for a knee with infection after a total arthroplasty. J Bone Joint Surg Am. 1987;69:1013–21.

    PubMed  CAS  Google Scholar 

  22. Morrey BF, editor. Reconstructive surgery of the joints. 2nd ed. New York: Churchill-Livingstone; 1996.

    Google Scholar 

  23. Sculco TP. The economic impact of infected total joint arthroplasty. Instr Course Lect. 1993;42:349–51.

    PubMed  CAS  Google Scholar 

  24. Volin SJ, Hinrichs SH, Garvin KL. Two-stage reimplantation of total joint infections. Clin Orthop. 2004;427:94–100.

    Article  PubMed  Google Scholar 

  25. Zimmerli W, Trampuž A, Ochsner P. Prosthetic joint infections. N Engl J Med. 2004;351:1645–54.

    Article  PubMed  CAS  Google Scholar 

  26. Lieberman JR, Callaway GH, Salvati EA, Pellicci PM, Brause BD. Treatment of the infected total hip arthroplasty with a two-stage reimplantation protocol. Clin Orthop. 1994;301:205–12.

    PubMed  Google Scholar 

  27. Nestor BJ, Hanssen AD, Ferrer-Gonzalez R, Fitzgerald RH. The use of porous prostheses in delayed reconstruction of total hip replacements that have failed because of infection. J Bone Joint Surg Am. 1994;76:349–59.

    PubMed  CAS  Google Scholar 

  28. Trampuž A, Zimmerli W. Prosthetic joint infections: update in diagnosis and treatment. Swiss Med Wkly. 2005;135:243–51.

    PubMed  Google Scholar 

  29. Colyer RA, Capello WN. Surgical treatment of the infected hip implant. Two-stage reimplantation with a one-month interval. Clin Orthop. Relat.Res. 1994;298:75–9.

    Google Scholar 

  30. Tsukajama DT, Estrada R, Gustilo RB. Infections after total hip arthroplasty: a study of the treatment of one hundred and six infections. J Bone Joint Surg Am. 1996;78:512–23.

    Google Scholar 

  31. Mont MA, Waldman BJ, Hungerford DS. Evaluation of preoperative cultures before second stage reimplantation of a total knee prosthesis complicated by infection. J Bone Joint Surg Am. 2000;82:1552–7.

    PubMed  Google Scholar 

  32. Garvin KL, Evans BG, Salvati EA, Brause BD. Palacos gentamicin for the treatment of deep periprosthetic hip infections. Clin Orthop. 1994;298:97–105.

    PubMed  Google Scholar 

  33. Haddad FS, Muirhead-Allwood SK, Manktelow AR, Bacarese-Hamilton I. Two stage uncemented revision hip arthroplasty for infection. J Bone Joint Surg Br. 2000;82:689–94.

    Article  PubMed  CAS  Google Scholar 

  34. Fehring TK, Calton TF, Griffin WL. Cementless fixation in 2-stage reimplantation for periprosthetic sepsis. J Arthroplasty. 1999;14:175–81.

    Article  PubMed  CAS  Google Scholar 

  35. English H, Timperley AJ, Dunlop D, Gie G. Impaction grafting of the femur in two-stage revision for infected total hip replacement. J Bone Joint Surg Br. 2002;84:700–5.

    Article  PubMed  CAS  Google Scholar 

  36. Alexeeff M, Mahomed N, Morsi E, Garbuz D, Gross A. Structural allograft in two-stage revisions for failed septic hip arthroplasty. J Bone Joint Surg Br. 1996;78:213–6.

    PubMed  CAS  Google Scholar 

  37. Steckelberg JM, Osmon DR. Prosthetic joint infection. In: Bisno AL, Waldvogel FA, editors. Infections associated with indwelling medical devices. 3rd ed. Washington, DC: American Society for Microbiology; 2000. p. 173–209.

    Google Scholar 

  38. Fitzgerald Jr RH, Arthroplasty ITH. Diagnosis and treatment. J Am Acad Orthop Surg. 1995;3:249–62.

    PubMed  Google Scholar 

  39. Zimmerli W, Ochsner PE. Management of infection associated with prosthetic joints. Infection. 2003;31:99–108.

    Article  PubMed  CAS  Google Scholar 

  40. Windsor RE, Insall JN, Urs WK, Miller DV, Brause BD. Two-stage reimplantation for the salvage of total knee arthroplasty complicated by infection. Further follow-up and refinement of indications. J Bone Joint Surg Am. 1990;72:272–8.

    PubMed  CAS  Google Scholar 

  41. Lonner JH, Barrack R, Fitzgerald Jr RH, Hanssen AD, Windsor ER. Infection in total knee arthroplasty: part II. Treatment. Am J Orthop. 1999;28:592–7.

    PubMed  CAS  Google Scholar 

  42. Bengtson S, Knutson K. The infected knee arthroplasty. A 6-year follow-up of 357 cases. Acta Orthop Scand. 1991;62:301–11.

    Article  PubMed  CAS  Google Scholar 

  43. Hirakawa K, Stulberg BN, Wilde AH, Bauer TW, Secic M. Results of 2-stage reimplantation for infected total knee arthroplasty. J Arthroplasty. 1998;13:22–8.

    Article  PubMed  CAS  Google Scholar 

  44. Teeny SM, Dorr L, Murata G, Conaty P. Treatment of infected total knee arthroplasty. Irrigation and debridement versus two-stage reimplantation. J Arthroplasty. 1990;5:35–9.

    Article  PubMed  CAS  Google Scholar 

  45. Langlais F. Can we improve the results of revision arthroplasty for infected total hip replacement? J Bone Joint Surg Br. 2003;85:637–40.

    PubMed  Google Scholar 

  46. Fisman DN, Reilly DT, Karchmer AW, Goldie SJ. Clinical effectiveness and cost-effectiveness of two management strategies for infected total hip arthroplasty in the elderly. Clin Infect Dis. 2001;32:419–30.

    Article  PubMed  CAS  Google Scholar 

  47. Kilgus M. Results of periprosthetic hip and knee infections caused by resistant bacteria. Clin Orthop. 2002;404:116–24.

    Article  PubMed  Google Scholar 

  48. Hsieh PH, Shih CH, Chang YH, Lee MS, Yang WE. Two-stage revision hip arthroplasty for infection: comparison between the interim use of antibiotic-loaded cement beads and a spacer prothesis. J Bone Joint Surg. 2004;86:1989–97.

    PubMed  Google Scholar 

  49. Yamamoto K, Miyagawa N, Masaoka T, Katori Y, Shishido T, Imakiire A. Clinical effectiveness of antibiotic-impregnated cement spacers for the treatment of infected implants of the hip joint. J Orthop Sci. 2003;8:823–8.

    Article  PubMed  Google Scholar 

  50. van de Belt H, Neut D, Schenk W, van Horn JR, van de Mei HC, Busscher HJ. Infection of orthopedic implants and the use of antibiotic-loaded bone cements. A review. Acta Orthop Scand. 2001;72:557–71.

    Article  PubMed  Google Scholar 

  51. Fang-Yao C, Chuan-Mu C, Chien-Fu JL, Wai Hee L. Cefuroxime-impregnated cement in primary total knee arthroplasty. A prospective randomized study of three hundred and forty knees. J Bone Joint Surg Am. 2002;84:759–62.

    Google Scholar 

  52. Leunig M, Chosa E, Speck M, Ganz R. A cement spacer for two-stage revision of infected implants of the hip joint. Int Orthop. 1998;22:209–14.

    Article  PubMed  CAS  Google Scholar 

  53. Jung J, Schmid NV, Kelm J, Schmitt E, Anagnostakos K. Complications after spacer implantation in the treatment of hip joint infections. Int J Med Sci. 2009;2:265–73.

    Article  Google Scholar 

  54. Buchholz HW, Engelbrecht H. Depot effects of various antibiotics mixed with palacos resins. Chirurg. 1970;41:511–5.

    PubMed  CAS  Google Scholar 

  55. Marks KE, Nelson CL, Lautenschlager EP. Antibiotic impregnated acrylic bone cement. J Bone Joint Surg Am. 1976;58:358–64.

    PubMed  CAS  Google Scholar 

  56. Kuechle DK, Landon GC, Musher DM, Noble PC. Elution of vancomycin, daptomycin, and amikacin from acrylic bone cement. Clin Orthop. 1991;264:302–8.

    PubMed  Google Scholar 

  57. Tunney MM, Ramage G, Patrick S. Antimicrobial susceptibility of bacteria isolated from orthopedic implants following revision hip surgery. Antimicrob Agents Chemother. 1998;42:3002–5.

    PubMed  CAS  Google Scholar 

  58. Taggart T, Kerry M, Norman P, Stockley I. The use of vancomycin-impregnated cement beads in the management of infection of prosthetic joints. J Bone Joint Surg Br. 2002;84:70–2.

    Article  PubMed  CAS  Google Scholar 

  59. Springer BD, Lee GC, Osmon D. Systemic safety of high-dose antibiotic-loaded cement spacers after resection of an infected total knee arthroplasty. Clin Orthop. 2004;427:47–51.

    Article  PubMed  Google Scholar 

  60. Wininger DA, Fass RJ. Antibiotic-impregnated cement and beads for orthopedic infections. Antimicrob Agents Chemother. 1996;40:2675–9.

    PubMed  CAS  Google Scholar 

  61. Ure KJ, Amstutz HC, Nasser S, Schmalzried TP. Direct-exchange arthroplasty for the treatment of infection after total hip replacement. An average ten-year follow-up. J Bone Joint Surg Am. 1998;80:961–8.

    PubMed  CAS  Google Scholar 

  62. Raut VV, Siney PD, Wroblewski BM. One-stage revision of total hip arthroplasty for deep infection. Long-term followup. Clin Orthop. 1995;321:202–7.

    PubMed  Google Scholar 

  63. Hope PG, Kristinsson KG, Norman P, Elson RA. Deep infection of cemented total hip arthroplasties caused by coagulase-negative staphylococci. J Bone Joint Surg Br. 1989;71:851–5.

    PubMed  CAS  Google Scholar 

  64. Kordelle J, Frommelt L, Klüber D, Seemann K. Results of one-stage endoprosthesis revision in periprosthetic infection cause by methicillin-resistant Staphylococcus aureus. Z Orthop Ihre Grenzgeb. 2000;138:240–4.

    Article  PubMed  CAS  Google Scholar 

  65. Gille J, Ince A, Katzer A, Loehr JF. Single-stage revision of peri-prosthetic infection following total elbow replacement. J Bone Joint Surg Br. 2006;88:1341–6.

    Article  PubMed  CAS  Google Scholar 

  66. Crockarell JR, Hanssen AD, Osmon DR, Morrey BF. Treatment of infection with debridement and retention of the components following hip arthroplasty. J Bone Joint Surg Am. 1998;80:1306–13.

    PubMed  CAS  Google Scholar 

  67. Laffer RR, Graber P, Ochsner PE, Zimmerli W. Outcome of prosthetic knee-associated infection: evaluation of 40 consecutive episodes at a single centre. Clin Microbiol Infect. 2006;12:433–9.

    Article  PubMed  CAS  Google Scholar 

  68. Tintle SM, Forsberg JA, Potter BK, Islinger RB, Andersen RC. Prosthesis retention, serial debridement, and antibiotic bead use for treatment of infection following total joint arthroplasty. Orthopedics. 2009;32:87.

    PubMed  Google Scholar 

  69. Zimmerli W, Widmer AF, Blatter M, Frei R, Ochsner PE. Role of rifampin for treatment of orthopedic implant-related staphylococcal infections: a randomized controlled trial. Foreign-Body Infection (FBI) Study Group. JAMA. 1998;279:1537–41.

    Article  PubMed  CAS  Google Scholar 

  70. Waldman BJ, Hostin E, Mont MA, Hungerford DS. Infected total knee arthroplasty treated by arthroscopic irrigation and debridement. J Arthroplasty. 2000;15:430–6.

    Article  PubMed  CAS  Google Scholar 

  71. Dixon P, Parish EN, Cross MJ. Arthroscopic debridement in the treatment of the infected total knee replacement. J Bone Joint Surg Br. 2004;86-B:39–42.

    Google Scholar 

  72. Hyman JL, Salvati EA, Laurencin CT, Rogers DE, Maynard M, Brause DB. The arthroscopic drainage, irrigation, and debridement of late, acute total hip arthroplasty infections: average 6-year follow up. J Arthroplasty. 1999;8:903–10.

    Article  Google Scholar 

  73. Byren I, Bejon P, Atkons BL, Anqus B, Masters S, McLardy-Smith P, Gindle R, Berendt A. One hundred and twelve infected arthroplasties treated with “DIAR” (debridement, antibiotics, and implant retention): antibiotic duration and outcome. J Antimicrob Chemother. 2009;63:1264–71.

    Article  PubMed  CAS  Google Scholar 

  74. Estes CS, Beauchamp CP, Clarke HD, Spangehl MJ. A two-stage retention debridement protocol for acute periprosthetic joint infections. Clin Orthop Relat Res. 2010;468:2029–38.

    Article  PubMed  Google Scholar 

  75. Kelm J, Schmitt E, Anagnostakos K. Vacuum-assisted closure in the treatment of early hip joint infections. Int J Med Sci. 2009;6:241–6.

    Article  PubMed  CAS  Google Scholar 

  76. Drancourt M, Stein A, Argenson JN, Roiron R, Groulier P, Raoult D. Oral treatment of Staphylococcus spp. infected orthopaedic implants with fusidic acid or ofloxacin in combination with rifampicin. J Antimicrob Chemother. 1997;39:235–40.

    Article  PubMed  CAS  Google Scholar 

  77. Stein A, Bataille JF, Drancourt M, Curvale G, Argenson JN, Groulier P, Raoult D. Ambulatory treatment of multidrug-resistant Staphylococcus-infected orthopedic implants with high-dose oral co-trimoxazole (trimethoprim-sulfamethoxazole). Antimicrob Agents Chemother. 1998;42:3086–91.

    PubMed  CAS  Google Scholar 

  78. Brouqui P, Rousseau MC, Stain A, Drancourt M, Raoult D. Treatment of Pseudomonas aeruginosa-infected orthopedic prostheses with ceftazidime-ciprofloxacin antibiotic combination. Antimicrob Agents Chemother. 1995;39:2423–5.

    Article  PubMed  CAS  Google Scholar 

  79. Brandt CM, Sistrunk WW, Duffy MC, Hanssen AD, Steckelberg JM, Ilstrup DM, Osmon DR. Staphylococcus aureus prosthetic joint infection treated with debridement and prosthesis retention. Clin Infect Dis. 1997;24:914–9.

    Article  PubMed  CAS  Google Scholar 

  80. Tattevin P, Cremieux AC, Pottier P, Huten D, Carbon C. Prosthetic joint infection: when can prosthesis salvage be considered? Clin Infect Dis. 1999;29:292–5.

    Article  PubMed  CAS  Google Scholar 

  81. Meehan AM, Osmon DR, Duffy CT, Hanssen AD, Keating MR. Outcome of penicillin-susceptible streptococcal prosthetic joint infection treated with debridement and retention of the prosthesis. Clin Infect Dis. 2003;36:845–9.

    Article  PubMed  CAS  Google Scholar 

  82. Schoifet SD, Morrey BF. Treatment of infection after total knee arthroplasty by debridement with retention of the components. J Bone Joint Surg Am. 1990;72:1383–90.

    PubMed  CAS  Google Scholar 

  83. Berdal JE, Skramm I, Mowinckel P, Gulbrandsen P, Bjornholt JV. Use of rifampicin and ciprofloxacin combination therapy after surgical debridement in the treatment of early manifestation prosthetic joint infections. Clin Microbiol Infect. 2005;11:834–55.

    Article  Google Scholar 

  84. Van Kleunen JP, Knox D, Garino JP, Lee G-C. Irrigation and debridement and prosthesis retention for treating acute prosthetic infections. Clin Orthop Relat Res. 2010;468:2024–8.

    Article  PubMed  Google Scholar 

  85. Widmer AF, Gaechter A, Ochsner PE, Zimmerli W. Antimicrobial treatment of orthopedic implant-related infections with rifampin combinations. Clin Infect Dis. 1992;14:1251–3.

    Article  PubMed  CAS  Google Scholar 

  86. Everts RJ, Chambers ST, Murdoch DR, Rothwell AG, Mc Kie J. Successful antimicrobial therapy and implant retention for streptococcal infections of prosthetic joints. ANZ J Surg. 2004;74:210–4.

    Article  PubMed  Google Scholar 

  87. El Helou OC, Berbari EF, Marculescu CE, El Atrouni WI, Razonable RR, Steckelberg JM, Hanssen AD, Osmon DR. Outcome of enterococcal prosthetic joint infections: is combination systemic therapy superior to monotherapy? Clin Infect Dis. 2008;47:903–9.

    Article  PubMed  Google Scholar 

  88. Trebše R, Milošev I, Kovač S, Mikek M, Pišot V. The isoelastic total hip replacement: a fourteen to seventeen years follow-up study. Acta Orthop. 2005;76:169–76.

    Article  PubMed  Google Scholar 

  89. Berbari EF, Osmon DR, Duffy MC, Harmssen RN, Mandrekar JN, Hanssen AD, Steckelberg JM. Outcome of prosthetic joint infection in patients with rheumatoid arthritis: the impact of medical and surgical therapy in 200 episodes. Clin Infect Dis. 2006;42:216–23.

    Article  PubMed  Google Scholar 

  90. Aboltins CA, Page MA, Buising KL, Jenney AW, Daffy JR, Choong PF, Stanley PA. Treatment of staphylococcal prosthetic joint infections with debridement, prosthesis retention and oral rifampicin and fusidic acid. Clin Microbiol Infect. 2007;13:586–91.

    Article  PubMed  CAS  Google Scholar 

  91. Soriano A, Garcia S, Ortega M, Almela M, Gallart X, Vila J, Sierra J, Tomas X, Martinez JA, Mensa J. Treatment of acute infection of total or partial hip arthroplasty with debridement and oral chemotherapy. Med Clin. 2003;121:81–5.

    Article  Google Scholar 

  92. Goulet JA, Pellici PM, Brause BD, Salvati EM. Prolonged suppression of infection in total hip arthroplasty. J Arthroplasty. 1998;3:109–16.

    Article  Google Scholar 

  93. Rao N, Crossett LS, Sinha RK, Le Frock JL. Long term suppression of infection in total joint arthroplasty. Clin Orthop. 2003;414:55–60.

    Article  PubMed  Google Scholar 

  94. Segreti J, Nelson JA, Trenholme GM. Prolonged suppressive antibiotic therapy for infected orthopedic implants. Clin Infect Dis. 1998;27:711–3.

    Article  PubMed  CAS  Google Scholar 

  95. Venugopalan V, Martin CA. Selecting anti-infective agents for the treatment of bone infections: new anti-infective agents and chronic suppressive therapy. Orthopedics. 2007;30:832–4.

    PubMed  Google Scholar 

  96. Sin JG, Berbari EF, Karchmer AW. Prosthetic joint infections. Infect Dis Clin North Am. 2005;19:885–914.

    Article  Google Scholar 

  97. Patel K, Cheshire D, Vance A. Oral and systemic effects of prolonged minocycline therapy. Br Dent J. 1998;185:560–2.

    Article  PubMed  CAS  Google Scholar 

  98. Marculescu CE, Berbari EF, Hanssen AD, Steckelberg JM, Harmsen SW, Mandrekar JN, Osmon DR. Outcome of prosthetic joint infections treated with debridement and retention of components. Clin Infect Dis. 2006;42(4):471–8.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department for Bone Infections and Adult reconstructions, Orthopaedic Hospital Valdoltra, Jadranska cesta 31, Ankaran, SI-6286, Slovenia

    Rihard Trebše M.D., Ph.D. & Aleš Berce M.D.

Authors
  1. Rihard Trebše M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aleš Berce M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rihard Trebše M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Orthopedic Hospital Valdoltra, Ankaran, 6280, Koper, Slovenia

    Rihard Trebše

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag London

About this chapter

Cite this chapter

Trebše, R., Berce, A. (2012). Current Treatment Strategies in Prosthetic Joint Infections. In: Trebše, R. (eds) Infected Total Joint Arthroplasty. Springer, London. https://doi.org/10.1007/978-1-4471-2482-5_20

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-2482-5_20

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2481-8

  • Online ISBN: 978-1-4471-2482-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation