Clinical practice. Infection associated with prosthetic joints.
review · Level V
Where this comes from
- Record sourced from PubMed, PMID 19692690.
- Also identified by DOI 10.1056/NEJMcp0905029 and PMC identifier 2850113.
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Abstract
A 62-year-old woman with osteoarthritis presents with a 7-month history of progressively worsening left hip pain radiating to the groin, 8 months after undergoing total left-hip arthroplasty. The pain has not responded to nonsteroidal antiinflammatory drugs. Physical examination reveals a sinus tract overlying her left hip. Her leukocyte count is 8000 per cubic millimeter, and the C-reactive protein (CRP) level is 15.5 mg per liter. A radiograph shows loosening of the prosthesis at the bone–cement interface. Synovial-fluid aspirate shows 15×10<sup>3</sup> cells per cubic millimeter (89% neutrophils); cultures of an aspirate from the hip grow <i>Staphylococcus epidermidis</i>. How should her case be managed?
Medical subject headings
- Arthroplasty, Replacement, Hip
- Hip Prosthesis
- Prosthesis-Related Infections
- Staphylococcal Infections
- Staphylococcus epidermidis
Anatomy
- hip