The Arthroplasty Nightmare: Periprosthetic Joint Infection of the Hip and Knee
A periprosthetic joint infection (PJI) is the most devastating complication in total joint arthroplasty. It is not merely a soft tissue infection; it is a highly organized, biofilm-protected bacterial fortress bonded directly to the metal and plastic implant. Eradicating it requires brutal surgical excision and massive antibiotic therapy. Periprosthetic Joint Infection of the Hip and Knee is a fiercely focused, highly algorithmic surgical manual dedicated exclusively to diagnosing and destroying these infections. This volume provides the exact blueprints required to salvage the limb and the patient’s life.
Mastering the Biofilm Paradigm
The core philosophy of this text is that bacteria on metal act differently than bacteria in tissue. The authors aggressively detail the biology of the glycocalyx biofilm. It dictates exactly why standard systemic antibiotics are useless against mature biofilms and mandates the absolute necessity of radical, aggressive surgical debridement or complete implant removal.
Navigating Diagnostic Criteria and Surgical Algorithms
The book provides a masterclass in the Musculoskeletal Infection Society (MSIS) criteria. It dictates the exact clinical pathways for differentiating aseptic loosening from indolent PJI using synovial fluid aspiration (alpha-defensin, leukocyte esterase, cell counts). It rigorously details the surgical algorithms: when to perform a simple Debridement, Antibiotics, and Implant Retention (DAIR), versus the grueling, multi-stage revision utilizing an antibiotic-loaded cement spacer.
Frequently Asked Questions (FAQs)
Does this book cover primary joint replacement?
Only in the context of *prevention* (e.g., operating room airflow, patient optimization). The vast majority of the text focuses on what to do when the primary joint has catastrophically failed due to infection.
Who is the primary audience?
It is the absolute, mandatory surgical atlas for Orthopedic Arthroplasty Surgeons, Infectious Disease Specialists, and Orthopedic Traumatologists managing revisions.
