Patients who have had joint replacement surgery are prone to get postoperative infections at those joints. When infection extends to the prosthetic joint, the infectious diseases standard of care is to recommend removal of the hardware and the use of a prolonged course of antibiotics intravenously, in order to realize the best chance for cure. In the vast majority of cases, failure to remove hardware and treat with IV antibiotics will result in failure to treat the infection fully. In general, when patients spike a fever several days after a hip replacement surgery, infection in the joint must be ruled out. Imaging (CT) and/or re-exploration are often necessary to rule out infection. If CT is performed and a fluid collection is seen, it is imperative to use IR-guidance or exploration to sample the collection for infection, then drain or debride as needed. The use of antibiotics alone is unlikely to fully treat a deep-seated joint infection. Again, if hardware is in place, such hardware would need to be removed to achieve cure. Although antibiotic spacers are often used by orthopedics as part of the treatment of hip infections, spacers are not a substitute for IV antibiotics. Patients with hip infections who have had their hardware removed and antibiotic spacers placed still require a long course of IV antibiotics. The acceptable duration of IV antibiotics is generally 6-8 weeks.
Organisms may include Klebsiella, Proteus, Staphyloccus (warneri) and Enterococcus (faecium).
Infection following joint replacement surgery medical expert witness specialties include orthopaedic surgery, upper extremity orthopaedic surgery, infectious disease, pediatric infectious disease, foot and ankle, orthopedic surgery, and pediatric orthopaedic surgery.