| Popis: |
Sepsis after total bone replacement may be a fulminant and life-threatening circumstance with systemic manifestations of bacterial proliferation, tissue necrosis, and the effects of related toxins. Frequently infection may be diagnosed during the early postoperative period. Systemic signs in association with wound inflammation and drainage lead to increasing suspicion validated by positive culture results. While this same fulminant course may occur long after a previously successful replacement arthroplasty, this is not the usual case. More frequently the late infection is seen as a knee that is not doing well. It is painful. swollen and hot. The radiographs show a progressive radiolucent line and there are reactive calcificatrons or ossifications at the joint capsule. Since the implications of infection are so important regarding, the options for joint salvage. such a knee must be repeatedly aspirated and cultured for all reasonable pathogens before proceeding. Often more than one aspiration will be necessary to obtain true positive results particularly with relatively indolent organisms. Similarly. the prior use of antibiotics may |
