Mr Chethan Jayadev PhD FRCS, Consultant Knee Surgeon, was delighted to be asked to talk on reconstructive options in the treatment of infected knee replacements by AllogenRx. The expert international panel was convened share their expertise on this complex problem.
Mr Jayadev, who runs a tertiary referral practice at the Royal National Orthopaedic Hospital alongside his private work with Grosvenor Orthopaedic Partners, is a key opinion leader in this field. AllogenRx are a commercial enterprise who provide innovative products that help surgeons manage the most difficult problems that infected joint replacement can cause.
In this short blog, Mr Jayadev highlights salient points in the early diagnosis and management of infection post knee replacement.
Hip and knee replacements are hugely successful for the vast majority of patients. However as small proportion of patients (less than 1 in 100) may develop an infection. This can be a superficial wound infection or a deep infection around the implants. This can occur during the patient’s hospital stay, at home during recovery and rehabilitation or even many years after surgery. Sometimes a serious infection elsewhere in your body can spread to your joint. Bacteria like metal and plastic implants where they can form what is known as a biofilm. They are then relatively protected from the body’s immune system and many antibiotics.
Deep infections are known as prosthetic joint infections, PJI. This is a devastating complication and presents a major challenge to patients and health care systems. It is the main cause of early failure of total joint replacements requiring revision surgery, sometimes on several occasions. The difficulty in treatment is compounded by the rise in global antimicrobial resistance.
Prevention is always better than cure, and your surgeon and hospital will always take the utmost precautions to limit the risk of PJI. In the event of infection early diagnosis and treatment is associated with better outcomes. Features to look out for include increased pain, swelling, stiffness, warmth and redness. The wound or scar may start draining fluid. Patients may become fatigued and have fevers, chills and sweats. Although it may sound counterintuitive, jumping straight to antibiotics should be avoided as it can prevent accurate diagnosis and encourage resistant infection. If there any concerns regarding prosthetic joint infection, one should seek further orthopaedic assessment as soon as possible to start appropriate investigations and treatment.
For those medical professionals seeking a more in-depth summary of the diagnosis and management of knee PJI, we recommend this summary paper. For medical professionals with a specialist interest in the most contemporary data on PJI, a link the International Consensus Meeting on Musculoskeletal Infection, including the latests consensus statements, can be found here.
Mr Jayadev only operates on the knee meaning he is a highly specialised knee surgeon: his practice varies from the management of sports injuries to the most complex joint reconstructions. To learn more about Mr Jayadev please see his profile. To book in to see him and to find out how he can help return you to optimal function, please contact us.