For every 100 people who get a hip or knee replacement, one or two will develop a serious, potentially debilitating infection — in some cases, years after the surgery.

To prevent some of those infections, would it make sense to pre-coat these high-tech artificial joints with antibiotics?

It may seem like a good idea, but nearly 80 years after the first hip-replacement surgery, no one knows for sure.

That question was among hundreds up for debate this week at a three-day conference at Thomas Jefferson University, concluding Friday. Researchers from more than 80 countries broke up into teams to review evidence for each strategy to combat infections in artificial hips, knees, and other joint implants, then presented their findings to the assembled crowd for a vote.

Does the use of opioids make a patient more likely to develop an infection? Should cell phones — a potential breeding ground for bacteria — be banned from the operating room? Are patients with poor dental hygiene at greater risk of joint infection?

“These are questions we face on a daily basis,” said conference co-host Javad Parvizi, a surgeon and director of clinical research at the Rothman Institute at Jefferson.

In addition to reviewing studies on hip and knee implants, which together account for more than 1 million surgeries each year in the United States, attendees at the meeting addressed strategies for surgeries on other joints, such as the shoulder, ankle, elbow, and spine — along with solutions that could apply to any orthopedic procedure.

One challenge the physicians face in preventing these infections: They are not common.

Within five years of surgery, joint infections occur in just 10 out of 1,000 hip-implant patients and 14 out of 1,000 who get artificial knees, according to a study this year by Parvizi and Steven M. Kurtz, a Drexel University biomedical engineer.

By Tom Avril | The Inquirer

Image Credit: Clem Murray

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