Strategies for Reducing the Risk of Implanted Joint Infections

Prosthetic joint infections (PJI) are a significant concern for patients undergoing joint replacement surgery, causing swelling, pain, and potentially severe problems. The cost of treating PJI in the U.S. is expected to reach over $1.6 billion in 2021.

Prevention of PJI is a shared responsibility between surgical practices and patients. In today's healthcare environment, patients need to take ownership of their health by losing weight, aggressively managing medical issues, and stopping smoking before surgery.

Hospital systems are taking steps to screen for common bacteria that cause joint infections, such as staphylococcus. Patients who are carriers are given antibiotic ointment and medicated wipes to use before surgery to decrease infection risk.

Patients with diabetes must ensure adequate control of their blood sugar, as surgery should be delayed until better diabetes is under control. The HbA1c blood test is often used to check diabetes control, and people whose HbA1c is above seven are at greater risk for PJI.

Maintaining a healthy weight before surgery can help reduce the risk of PJI. Ideally, a body mass index (BMI) less than 35 to 40 kg/m2 should be achieved before surgery. If a patient's BMI is over 40, their risk of complications may be up to seven times higher.

Quitting nicotine prior to surgery can also decrease infection risk, as patients who use nicotine are at a greater risk of having wound healing problems, which can lead to PJI.

In addition to patient-focused measures, hospital systems are employing strict aseptic surgical techniques, perioperative antibiotic prophylaxis, thorough preoperative patient assessment, and postoperative wound care to reduce the risk of PJI. The German health authorities recommend these measures to minimise the risk of PJI.

Patients should ask their surgeon what steps the hospital takes to manage the risk of infection. By taking personal responsibility and working with healthcare providers, patients can help reduce the burden of PJI on both themselves and hospital systems.

PJI compromises function and pain relief after surgery and can require a long-term, painful, and costly treatment plan. The cheapest and best way to avoid complications from PJI is through prevention.