Infections that arise in the body, particularly those that are transmitted via an open wound injury or that develop after surgery, can cause serious problems, which is why medical professionals are not only very careful to prevent any infection from taking hold but are also on the lookout for any early symptoms of infection, especially after surgery.
See the sections on infection from traumatic injury and infection of the hip.
Most soft tissue infections can be managed with antibiotic treatment.
Two infections specific to bones and joints are osteomyelitis and septic arthritis, both of which require careful management.
Where either are suspected general practitioners and other medical professionals refer these immediately to orthopaedic specialists.
Osteomyelitis
Treatment for osteomyelitis is dependent on the severity of the infection. Generally speaking, one or more of the following treatments are needed to clear the infection:
Non-Surgical
- Antibiotic treatment (generally 4-6 week course), or in more severe cases admission to hospital and intravenous delivery of antibiotic treatment.
- Pain medication.
- Treatment of aggravating factors (for example treatment of diabetes and / or lifestyle changes such as giving up smoking).
Surgical
- Debridement – surgery to flush and clean the infected bone.
- If infection affects a prosthetic component, revision surgery to replace.
- Skin graft.
- Limb amputation (in severe cases and as a last resort).
In general terms, the earlier osteomyelitis is diagnosed, the earlier treatment can begin and the greater the chances of a full and relatively speedy recovery.
Septic arthritis
Treatment for septic arthritis is dependent on the early identification of the specific bacteria that is causing the infection – this can be done by analysis of affected tissue or analysis of synovial fluid surrounding the joint.
Non-Surgical
The primary treatment is a course of intravenous antibiotics over several weeks, and when / if the infection responds to treatment, this may swap to oral antibiotics.
Treatment of septic arthritis where it has infected artificial joint components can be more difficult, as the bacteria can enter the biofilm on the surface of the metal components where antibiotic treatment is less effective.
Surgical
- Drainage of infected synovial fluid – this can be done non-surgically via needle aspiration, however some cases require an arthrotomy, which is where an opening is surgically created in the joint to allow the fluid to drain away.
- Lavage – this is the cleaning and flushing of infected fluid with a saline solution.
In most cases, surgery is performed using minimally invasive (arthroscopic) techniques.