Prosthetic Joint Infection Following Total Hip Arthroplasty—Effect of Choice of Bearing Surfaces and How to Investigate Further—A Review of the Literature
Introduction: Total
Hip Arthroplasty (THA) has proved to improve a patient’s quality of life. This procedure has become more
refined overtime, and
subsequently
there is huge variation in its execution. Prosthetic Joint Infection (PJI)
remains a disastrous complication following this procedure. Main body: This
article reviews the literature surrounding the various bearing surface options
and fixation
methods associated with the development of PJI. The current literature is
reviewed to best describe how to investigate PJI following THA. Discussion: There
is evidence supporting that no particular combination of articulating surfaces
increases the risk of developing PJI. Cement,
impregnated with antibiotics, has been proven to have a lower PJI rate over
uncemented prostheses. Conclusion: Further research is required to best determine the optimum choice of bearing surfaces and fixation methods. If PJI
is diagnosed, the cornerstone to its management is through a Multi-Disciplinary
Team (MDT) approach.
Cite this paper
Saad, A. and Shahban, S. A. (2018). Prosthetic Joint Infection Following Total Hip Arthroplasty—Effect of Choice of Bearing Surfaces and How to Investigate Further—A Review of the Literature. Open Access Library Journal, 5, e4663. doi: http://dx.doi.org/10.4236/oalib.1104663.
Zimmerli, W., Trampuz, A. and Ochsner, P. (2004) Prosthetic-Joint Infections. New England Journal of Medicine, 351, 1645-1654. https://doi.org/10.1056/NEJMra040181
Sharma, D., Douglas, J., Coulter, C., Weinrauch, P. and Crawford, R. (2008) Microbiology of Infected Arthroplasty: Implications for Empiric Peri-Operative Antibiotics. Journal of Orthopaedic Surgery, 16, 339-342. https://doi.org/10.1177/230949900801600314
Kurtz, S., Lau, E., Baykal, D. and Springer, B. (2017) Outcomes of Ceramic Bearings After Primary Total Hip Arthroplasty in the Medicare Population. The Journal of Arthroplasty, 32, 743-749. https://doi.org/10.1016/j.arth.2016.08.038
Hu, D., Yang, X., Tan, Y., Alaidaros, M. and Chen, L. (2015) Ceramic-on-Ceramic versus Ceramic-on-Polyethylene Bearing Surfaces in Total Hip Arthroplasty. Orthopedics, 38, e331-e338. https://doi.org/10.3928/01477447-20150402-63
Pitto, R. and Sedel, L. (2016) Periprosthetic Joint Infection in Hip Arthroplasty: Is There an Association between Infection and Bearing Surface Type? Clinical Orthopaedics and Related Research, 474, 2213-2218.
https://doi.org/10.1007/s11999-016-4916-y
Hexter, A., Hislop, S., Blunn, G. and Liddle, A. (2018) The Effect of Bearing Surface on Risk of Periprosthetic Joint Infection in Total Hip Arthroplasty. The Bone & Joint Journal, 100-B, 134-142. https://doi.org/10.1302/0301-620X.100B2.BJJ-2017-0575.R1
Engesaeter, L., Espehaug, B., Lie, S., Furnes, O. and Havelin, L. (2006) Does Cement Increase the Risk of Infection in Primary Total Hip Arthroplasty? Revision Rates in 56,275 Cemented and Uncemented Primary THAs Followed for 0 - 16 Years in the Norwegian Arthroplasty Register. Acta Orthopaedica, 77, 351-358.
https://doi.org/10.1080/17453670610046253
Yoon, B., Ha, Y., Lee, Y. and Koo, K. (2015) Postoperative Deep Infection after Cemented versus Cementless Total Hip Arthroplasty: A Meta-Analysis. The Journal of Arthroplasty, 30, 1823-1827. https://doi.org/10.1016/j.arth.2015.04.041
Minakawa, H., Stone, M., Wroblewski, B., Lancaster, J., Ingham, E. and Fisher, J. (1998) Quantification of Third-Body Damage and Its Effect on UHMWPE Wear with Different Types of Femoral Head. The Journal of Bone and Joint Surgery, 80, 894-899. https://doi.org/10.1302/0301-620X.80B5.8675
Ghanem, E., Antoci, V., Pulido, L., Joshi, A., Hozack, W. and Parvizi, J. (2009) The Use of Receiver Operating Characteristics Analysis in Determining Erythrocyte Sedimentation Rate and C-Reactive Protein Levels in Diagnosing Periprosthetic Infection Prior to Revision Total Hip Arthroplasty. International Journal of Infectious Diseases, 13, e444-e449. https://doi.org/10.1016/j.ijid.2009.02.017
Chryssikos, T., Parvizi, J., Ghanem, E., Newberg, A., Zhuang, H. and Alavi, A. (2008) FDG-PET Imaging Can Diagnose Periprosthetic Infection of the Hip. Clinical Orthopaedics and Related Research, 466, 1338-1342. https://doi.org/10.1007/s11999-008-0237-0
Peel, T., Buising, K. and Choong, P. (2010) Prosthetic Joint Infection: Challenges of Diagnosis and Treatment. ANZ Journal of Surgery, 81, 32-39. https://doi.org/10.1111/j.1445-2197.2010.05541.x
Love, C., Marwin, S. and Palestro, C. (2009) Nuclear Medicine and the Infected Joint Replacement. Seminars in Nuclear Medicine, 39, 66-78. https://doi.org/10.1053/j.semnuclmed.2008.08.007
Schinsky, M., Della Valle, C., Sporer, S. and Paprosky, W. (2008) Perioperative Testing for Joint Infection in Patients Undergoing Revision Total Hip Arthroplasty. The Journal of Bone and Joint Surgery-American Volume, 90, 1869-1875. https://doi.org/10.2106/JBJS.G.01255
Yee, D., Chiu, K., Yan, C. and Ng, F. (2013) Review Article: Joint Aspiration for Diagnosis of Periprosthetic Infection. Journal of Orthopaedic Surgery, 21, 236-240. https://doi.org/10.1177/230949901302100225