Why do joint replacement infections cause problems? Bacteria are usually well controlled by our immune system.

Once an infection is detected, our immune system rapidly responds, and attacks the infecting bacteria . However, implanted materials, like those found in a joint replacement, can all ow infections to persist. Our immune system is unable to attack bacteria that li ve on these implants, and these infections can become serious problems. If an in fection of an implant goes untreated, the problem can worsen, and the bacteria c an gain such a foothold that they can become a systemic problem. The reason infections are such a significant problem is that bacteria cannot be easily eliminated from a joint replacement implant. Despite excellent antibiotic s and preventative treatments, patients with a joint replacement infection often will require removal of the implanted joint in order to cure the infection. What is done to prevent infections of total joint replacements? At the time of surgery, there are several measures taken to minimize the risk of infection of a total joint replacement. Some of the steps are known to lower th e risk of infection, some are thought to help but not known. Among the most impo rtant, known measures to lower the risk of infection after total joint replaceme nt are: Antibiotics before and after surgery Antibiotics are given within one hour of the start of surgery (usually once in t he operating room) and continued for a short period following the procedure. Short operating time and minimal OR traffic Efficiency in the operation by your surgeon helps to lower the risk of infection by limiting the time the joint is exposed. Limiting the number of operating roo m personnel entering and leaving the room is thought to decrease risk of infecti on. Use of strict sterile technique and sophisticated sterilization techniques Care is taken to ensure the operating site is sterile, the instruments have been autoclaved and not exposed to any contamination, and the implants are packaged to ensure their sterility. After the operation, the risk of developing an infection from an outside source is reduced, but there is still a risk of developing an infection from the blood stream. Because of this, patients with a joint replacement implant should take a ntibiotics before invasive procedures such as dental work, colonoscopies, etc. I t is known that these procedures may cause a transient risk of bacteria entering the blood stream. Antibiotics will help control this and prevent joint infectio n. What happens when a total joint replacement becomes infected? When a total joint replacement becomes infected, it may loosen, become painful, and need to be removed. Unfortunately, even if the implant is washed clean durin g surgery, most types of infections require removal of the implant to cure the i nfection. Why did I get an infection after joint replacement surgery? There are several risk factors for developing an infection after a total joint r eplacement, but most patients have no identifiable cause for developing an infec tion. Some of the risk factors include: Immune deficiencies (e.g. HIV, lymphoma), or immune suppressive treatments (e.g. chemotherapy) Diabetes Rheumatoid arthritis Obesity