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BMJ 2009;338:b1773

Diagnosis and management of prosthetic joint infection

Philippa C Matthews, specialist registrar infectious diseases/microbiology, clinical research fellow123, Anthony R Berendt, consultant in infectious diseases12, Martin A McNally, consultant orthopaedic surgeon in limb reconstruction1, Ivor Byren, consultant in infectious diseases12
Hip Knee

  • Early diagnosis of prosthetic joint infection reduces morbidity and improves outcomes

  • Infection is eradicated and joint function is preserved in most patients who receive appropriate combined surgical and medical treatment

  • A multidisciplinary team is often needed for optimal diagnosis, treatment, and rehabilitation; specialist referral may be required.

  • Well fixed implants can be salvaged by aggressive debridement, antibiotics, and implant retention

  • Antibiotics are usually needed for three to six months if the prosthesis is retained, or for up to six weeks after revision arthroplasty


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