Gelenkempyeme und Periprothetische Infektionen. Ergebnisse nach Operativer Versorgung

A total of 31 patients with a proven methicillin and oxacillin-resistant Staphylococcus aureus (MRSA/ORSA) infection of a joint or joint replacement were treated, 29 by surgical methods and 2 had to be treated conservatively due to severe accompanying illnesses. Depending on the stage of joint empyema, prior treatment, the extent of infection and level of joint damage, an open joint preserving operation or a primary joint resection was performed. A synovialectomy was performed for all surgery patients and an antibiotic carrier was implanted into the joint. In 28 out of 31 patients the infection was considered to be alleviated at the time of this retrospective study. Despite elaborate, complex and costly operative treatment only 2 joints and 2 hip replacements could be preserved. The clinical results are regarded as satisfactory with sometimes considerable limitations to mobility and quality of life. The results show that despite optimal treatment of joint empyema and infections of joint replacements with MRSA/ORSA, it is only rarely possible to preserve the joint. In most cases an arthrodesis or resection of the joint is necessary. In rare cases an amputation or exarticulation of the affected joint is required.