Contribution to the International Consensus meeting - 2013

A collection of papers by Prof. EEG Lautenbach, relevant to the deliberations of the International Consensus Meeting on Periprosthetic Joint Infection, organized by the MusculoSkeletal Infection Society and held in Philadelphia, PA on 1st August 2013.

The Papers

• 1. Leica Presentation (PDF) - Lautenbach Estimate of the relative Indication and Contraindication for Arthroplasty: A scoring system which objectively determines the justification, priority and risk of total joint replacement.
• 2. The Risk of Infection (PDF) - Infection around a total joint replacement does not readily spread to other arthroplasties or implants in healthy immune competent individuals. It does so frequently in immune compromised individuals.
• 3. Dental Prophylaxis for Arthroplasty (PDF) - The place of antibiotic prophylaxis for dental procedures in patients who have had total joint replacement is controversial. Although the concept has been popular, convincing microbiological evidence of a connection between the dental procedure and the consequent infection around the joint replacement is rare.
• 4. Calibrating the Systemic Effects of Infection with Laboratory Investigations (PDF) - The need to accurately assess the intensity of infection arises when you aim to diagnose infection which is dubious, subtle or confused with other pathology. On the other hand it should help one to logically determine how long treatment for infection should continue. It is of crucial importance when one is contemplating the insertion of total joint arthroplasty. It can often settle the question whether an existing arthroplasty is simply loose or whether it is infected as well. As a research tool it helps one define the degree of infection and of course whether you have cured an infection eventually. Finally in medico legal disputes this information can be invaluable.
• 5. Overall Management of Infections around Total Knee and Hip Arthroplasties (PDF) - The management of 521 infected total hips and 262 infected total knees encountered between 1970 and 2001 is discussed. A range of treatment protocols was used, varying according to the acuteness and severity of the infection. The outcomes of the different protocols are described.
• 6. Arthrodesis after Failed Total Knee Replacement (PDF) - A technique for obtaining fixation of the knee following extensive destruction of bone, resulting from infection of a total joint replacement. The technique enables subsequent surgery to eradicate infection after arthrodesis has been achieved without foregoing the fusion of the two bones.
• 7. Microbiology of Arthroplasty Infection (PDF) - In order to approach the subject of prophylaxis and management of infection in any field, it is absolutely essential to understand the spectrum of micro-organisms encountered to deal with those infections. When treating a particular infection it is obviously an advantage to know the occupying bacteria and their antibiotic sensitivity before operation so that one can administer the correct antibiotic from the start. I would like to present a survey of the bacteria isolated from infected knee and hip arthroplasties at different stages in the management of infection.

[CBL] Revised: 2013-07-22