New IDSA guidelines aim to reduce death, disability, and cost of prosthetic joint infections

December 07, 2012

[EMBARGOED FOR DEC. 7, 2012, ARLINGTON, Va.] - Of the one million people each year who get hips and knees replaced, as many as 20,000 will get an infection in the new joint, a number that is expected to skyrocket in the next 20 years. Multispecialty physician teams need to work together to reduce disability, death and costs associated with the ever-growing number of these prosthetic joint infections, note the first guidelines on the topic being released by the Infectious Diseases Society of America (IDSA).

"There are very few things that improve quality of life as much as joint replacement, but 1 to 2 percent of the time the new joint can become infected, even when precautions are taken," said Douglas R. Osmon, MD, associate professor of medicine in the division of infectious diseases at Mayo Clinic, Rochester, Minn. "There are many different ways to treat these infections to achieve the same outcome. The guidelines provide a framework to help multidisciplinary teams choose the best method of diagnosis and treatment for each patient."

Hips, knees and other joint replacements - such as shoulders and elbows - can become infected during the surgery or months or even years later.

The guidelines, which are being published online today in the journal Clinical Infectious Diseases, outline the evidence and opinions regarding methods that are appropriate to diagnose the infections early and treat them most effectively, according to patients' specific situations. Most infections require long courses of antibiotics and surgery, which can range from washing out the infected area to removal and replacement of the joint to permanent removal of the prosthesis to amputation.

Multidisciplinary teams should include an orthopedist and an infectious diseases specialist, as well as other specialists on a case-by-case basis. For instance, if the patient is older and has heart disease, an internist should be involved, and if the surgical wound is difficult to close, a plastic surgeon should be consulted, said Dr. Osmon. In rural areas with few specialists, doctors should consider consulting with infectious diseases specialists or orthopedists at referral centers.

The guidelines describe the best methods for diagnosis of prosthetic joint infections. These infections can be difficult to diagnose, and not all are obvious, notes Dr. Osmon. Also, problems with joint replacements - particularly loosening of the prosthesis and pain - may be caused by infection or by problems in the materials in the device itself.

Among the recommendations in the guidelines:"The number of people suffering from prosthetic joint infections will continue to grow because, although we are getting better at preventing infection, that is countered by the increase in older and sicker people having joint replacement," said Dr. Osmon.

The nine-member prosthetic joint infections guidelines panel comprises experts from the United States and Europe representing the infectious diseases and orthopedic specialties. In addition to Dr. Osmon, the panel includes: Elie F. Berbari, Anthony R. Berendt, Daniel Lew, Werner Zimmerli, James M. Steckelberg, Nalini Rao, Arlen Hanssen and Walter R. Wilson.
-end-
IDSA has published more than 50 treatment guidelines on various conditions and infections, ranging from HIV/AIDS to Clostridium difficile. As with other IDSA guidelines, the prosthetic joint infections guidelines will be available in a smartphone format and a pocket-sized quick-reference edition. The full guidelines are available free on the IDSA website at www.idsociety.org. Note: For an advance copy of the prosthetic joint infections guidelines, to be published in the Jan. 1, 2013 issue of Clinical Infectious Diseases, please contact Jerica Pitts at 312-558-1770 or jpitts@pcipr.com. The guidelines are embargoed until 12:01 a.m. EST on Dec. 7, 2012.

AT A GLANCE

A million people have their hips and knees replaced every year, but as many as 20,000 of them (2 percent) will get an infection in the new joint during their lifetimes.

The first prosthetic joint infections guidelines released by the Infectious Diseases Society of America (IDSA) suggest different specialists should work together to best treat patients based on individual circumstances.

The guidelines provide a framework for the various options for diagnosis and treatment of prosthetic joint infections.

Treatment of prosthetic joint infection can range from washing out the infected wound to replacement of the prosthesis to amputation.Founded in 1979, Clinical Infectious Diseases publishes clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty.

The Infectious Diseases Society of America (IDSA) is an organization of physicians, scientists, and other health care professionals dedicated to promoting health through excellence in infectious diseases research, education, patient care, prevention, and public health. The Society, which has nearly 10,000 members, was founded in 1963 and is based in Arlington, Va. For more information, see www.idsociety.org.

Infectious Diseases Society of America

Related Infectious Diseases Articles from Brightsurf:

Understanding the spread of infectious diseases
Physicists at M√ľnster University (Germany) have shown in model simulations that the COVID-19 infection rates decrease significantly through social distancing.

Forecasting elections with a model of infectious diseases
Election forecasting is an innately challenging endeavor, with results that can be difficult to interpret and may leave many questions unanswered after close races unfold.

COVID-19 a reminder of the challenge of emerging infectious diseases
The emergence and rapid increase in cases of coronavirus disease 2019 (COVID-19), a respiratory illness caused by a novel coronavirus, pose complex challenges to the global public health, research and medical communities, write federal scientists from NIH's National Institute of Allergy and Infectious Diseases (NIAID) and from the Centers for Disease Control and Prevention (CDC).

Certain antidepressants could provide treatment for multiple infectious diseases
Some antidepressants could potentially be used to treat a wide range of diseases caused by bacteria living within cells, according to work by researchers in the Virginia Commonwealth University School of Medicine and collaborators at other institutions.

Opioid epidemic is increasing rates of some infectious diseases
The US faces a public health crisis as the opioid epidemic fuels growing rates of certain infectious diseases, including HIV/AIDS, hepatitis, heart infections, and skin and soft tissue infections.

Infectious diseases could be diagnosed with smartphones in sub-Saharan Africa
A new Imperial-led review has outlined how health workers could use existing phones to predict and curb the spread of infectious diseases.

The Lancet Infectious Diseases: Experts warn of a surge in vector-borne diseases as humanitarian crisis in Venezuela worsens
The ongoing humanitarian crisis in Venezuela is accelerating the re-emergence of vector-borne diseases such as malaria, Chagas disease, dengue, and Zika virus, and threatens to jeopardize public health gains in the country over the past two decades, warn leading public health experts.

Glow-in-the-dark paper as a rapid test for infectious diseases
Researchers from Eindhoven University of Technology (The Netherlands) and Keio University (Japan) present a practicable and reliable way to test for infectious diseases.

Math shows how human behavior spreads infectious diseases
Mathematics can help public health workers better understand and influence human behaviors that lead to the spread of infectious disease, according to a study from the University of Waterloo.

Many Americans say infectious and emerging diseases in other countries will threaten the US
An overwhelming majority of Americans (95%) think infectious and emerging diseases facing other countries will pose a 'major' or 'minor' threat to the U.S. in the next few years, but more than half (61%) say they are confident the federal government can prevent a major infectious disease outbreak in the US, according to a new national public opinion survey commissioned by Research!America and the American Society for Microbiology.

Read More: Infectious Diseases News and Infectious Diseases Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.