Infected Joints

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One of the most devastating occurrences in total knee and hip replacements are when infection occurs. Studies show infections occur in one to two percent of primary (first time) joint replacements and three to seven percent of revision surgeries. An increased risk of infection is noticed in patients who are diabetic, smokers, rheumatoid, and morbidly obese. If a joint infection is not treated properly it can result in a long hospital stay, considerable pain, disability, and many times amputation.

Advanced training and experience in the treatment of complex infections and revisions allows Dr. Buch to utilize a number of approaches to treat an infected joint. A significant percentage of the patients referred to our center are failed attempts from other surgeons to treat an infection or reconstruct a joint. Many orthopedic surgeons will take out an infected knee or hip but few have the training to treat the infection and put it back in properly. Dr. Buch also works closely with a multi disciplinary team including infectious disease doctors to treat, salvage, and reconstruct the most complex infections. Countless orthopedic publications show many of these types of infections end in amputation but a high percentage of these patients of infected joints are able to be saved thanks to the expertise our center provides. Dr. Buch treats more joint infections yearly then anyone in the Dallas-Fort Worth area and is world renown expert on joint infections. 

The most common types of joint infections Dr. Buch treats:

  • Cellulitis
  • Septic Arthritis
  • Osteomyelitis 
  • Septic Bursitis
  • Infectious Tenosynovitis 
  • Pyomyositis

Symptoms of a musculoskeletal infection:
  • Pain in the joint
  • Elevated body temperature
  • Swelling and redness
  • Lack of appetite
  • Fatigue
  • Elevated heart rate
  • Warm feeling skin over the joint

What are risk factors for bacterial musculoskeletal infections?
  • Previous joint surgery or an artificial implant
  • Lupus
  • Gout
  • Rhematoid arthritis
  • Psorasis
  • Thin skin or wounds on the skin
  • Weak immune system
  • Taking medications that suppress the immune system
  • A bacterial infection in another area of the body
  • Gum disease or periodental surgery
  • Diabetes
  • Smoking
  • Chronic urinary tract infections

Richard Buch, M.D. provides five recommendations for all patients who are seeking treatment for a musculoskeletal infection:

1. If you chose to have treatment by your current doctor or stay in your area make sure the surgeon is fellowship trained in complex joint revisions and has extensive experience treating complex infections. Most joint infections should be treated by a board certified, fellowship trained orthopedic oncologist as both are extensive components of their training. 

2. Make sure the hospital you chose has the appropriate support staff to handle joint infections. Many smaller hospitals do not have the experience in treating patients with infected joints which often require a multi disciplinary team of specialists to include infectious disease and plastic surgeons. 

3. Ask for a second opinion! It is your leg or arm we are working to save. 

4. Visit the American Academy of Orthopedic Surgery (AAOS) website to learn more about joint infections and the types of physicians who should be treating these conditions. 

5. Studies clearly illustrate and recommend being treated by a center who specializes in joint infections and complex revisions.