If a patient has an infection, should a total joint replacement be performed?

If a patient has an infection, should a total joint replacement be performed?

• A. Proceed as planned
• B. Defer until infection is resolved
• C. Schedule earlier
• D. Perform only diagnostic tests

Answer: (B)

When an infection is present, elective total joint replacement should be delayed until the infection is resolved. The reason is that placing an implant in the setting of infection greatly increases the risk of prosthetic joint infection, which can be difficult to treat because bacteria can form biofilms on the prosthesis and spread systemically. A clean, well-healing surgical field and adequate blood supply are essential for successful joint replacement, and active infection undermines both. Managing this involves treating the infection first—targeted antibiotics based on cultures, source control if needed, and monitoring until signs of infection and inflammatory markers improve. Once the infection is controlled and the patient is stable, the joint replacement can be performed with a much lower risk of complications. Choosing to proceed with surgery during infection or delaying it without addressing the infection would raise the risk of serious complications and poorer outcomes.

When an infection is present, elective total joint replacement should be delayed until the infection is resolved. The reason is that placing an implant in the setting of infection greatly increases the risk of prosthetic joint infection, which can be difficult to treat because bacteria can form biofilms on the prosthesis and spread systemically. A clean, well-healing surgical field and adequate blood supply are essential for successful joint replacement, and active infection undermines both.

Managing this involves treating the infection first—targeted antibiotics based on cultures, source control if needed, and monitoring until signs of infection and inflammatory markers improve. Once the infection is controlled and the patient is stable, the joint replacement can be performed with a much lower risk of complications.

Choosing to proceed with surgery during infection or delaying it without addressing the infection would raise the risk of serious complications and poorer outcomes.