Vasyuk S. Intraoperative prevention and treatment of periprosthetic infection after total hip or knee replacement

The intraoperative measures for prophylaxis of infection after total hip or knee replacement were substantiated, namely the effect of laminar clean air in the operating room. Introducing laminar clean air caused a decrease in total microbial count of the air by 60 times, and a decrease in particular matter > 0.3 ?m (PM0.3) count by 7289 times (p<0.001), which was associated with a shortening of mean postoperative hospital stay from 11.10±4.01 to 8.64±2.84, a decrease in percentage of patients who spent over 14 days in hospital after surgery from 7.3% to 2.2%, and a decrease in infection rate after total hip or knee replacement from 3.3% to 1.1%. Improved technique of two stage exchange arthroplasty of the hip using the designed antibiotic impregnated cement spacers made intraoperatively with the designed metallic molds was used in 49 patients with periprosthetic infection after total hip replacement. Infection eradication and good functional results were achieved in 89.5%. Mean Harris Hip Score at follow up was 87.18±6.44. Improved technique of two stage knee revision using the designed articulating antibiotic impregnated cement spacers was used in 20 patients with infected total knee replacement. Infection control and good functional results were achieved in 84.2%. At follow up, mean Knee Injury and Osteoarthritis Outcome Score was 67.9±6.2, mean Knee Society Score was 72.8±2.7.