With surgical processes available easily for the betterment of various conditions, implanted materials are now commonly used. These range from heart valves and angioplasty devices to orthopaedic implants for bone fractures and joint replacement materials. With development of materials and medicine, we have been able to overcome effects related to rejection by the body and allergies. However, foreign materials in the body are not protected by the body’s immune system. These are hence susceptible to attack by bugs that enter the body. Such peri-prosthetic infections can cause devastating complications. The most prevalent of these are with orthopaedic implants. Onlymyhealth reached out to Dr. Yogeesh D Kamat, Consultant Hip, Knee & Sports Injury Surgeon, KMC Hospital, BR Ambedkar Circle, Mangalore to know more about periprosthetic infections, why they occur and how they can be prevented.
What causes periprosthetic infections?
Most infections with prostheses (75%) occur due to deficiencies in aseptic precautions in the operation theatre. They may not be obvious at the time or immediately after surgery but can become evident much later, depending on the capacity of the bug and severity of the infection.
In a lesser proportion (one fourth), severe untreated infections like urinary/ chest (pneumonia) or sometimes minor surgical procedures, including dental, can cause bacteria to travel through the bloodstream and lodge on metal prosthesis thereby damaging them over time.
Many bacteria and fungi have the ability to stick to metal prostheses and form a wall around them that cannot be penetrated by the body’s immune system or administered antibiotics. They can hence persist and destroy the surrounding tissues causing just loosening of the implant or eventually generalised sepsis.
These infections will not subside unless and until the metal prostheses are removed. In cases of implants used for treating fractures, the role of the metal prosthesis is only until the fracture has healed. Hence a less severe infection can settle after the metal implant is removed without long- term consequences. In case of joint replacement surgery however, removal of the metal leaves a void and renders the joint functionless, thereby making the patient’s life and activity very difficult.
How to treat and prevent infections?
The best way to treat periprosthetic infections is to prevent them. Here are some suggestions by doctor to keep them at bay:
- Operating theatre standards, especially for joint replacement cases have to be adhered to without any compromise.
- There should be strict monitoring and transparent reporting by every hospital that undertakes such procedures and action should be taken if a rate of infection more than 0.5% is noted.
- If there is any suspicion of infection, it should be tackled aggressively.
- Empirically prescribing antibiotics commonly happens in the community and such practices often result in masking infections, increase resistance of the bacteria to normal antibiotics and cause further damage inside.
Periprosthetic infections can be life-threatening and so, they must be prevented. Hospitals and doctors must ensure that all the safety measures are followed to avert any possible risks.
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