Locations:
Search IconSearch

4 Ways to Prevent Prosthetic Joint Infection

What you need to know about prosthetic joint infection after surgery

film x-ray of osteoarthritis knee patient and artificial joint

According to orthopaedic surgeon Anokha Padubidri, MD, two of the most common questions asked at her outpatient clinic is, “Should I have joint replacement surgery done?” and “How old is too old for joint replacement?”

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

“There’s no age limit on who can safely undergo joint replacement surgery,” she says. But for some people, the risks that may follow surgery can outweigh the benefits.

“One of the more serious risks is a complication of total joint arthroplasty called prosthetic joint infection or periprosthetic infection,” Dr. Padubidri says. “It’s important for patients to know risks like PJI before considering surgery. There are also preventative steps they’ll need to consider to prevent this often debilitating and expensive complication if they do opt for it,” she says.

What is prosthetic joint infection (PJI)?

Prosthetic joint infection happens when bacteria around a replaced joint gets infected after surgery. It causes swelling, pain and other more severe problems that if not prevented may require a long-term, painful and costly treatment plan.

“This infection compromises both function and pain relief after surgery,” Dr. Padubidri says. “But it can’t be understated that patients can play a huge role in their own prevention of it.”

She points out that not only are these infections burdensome for patients, but also for hospital systems. PJI occurs in 0.5% to 2.5% of joint replacements in the United States alone. The cost to treat it in the U.S. is expected to reach more than $1.6 billion in 2021.

Advertisement

How to prevent prosthetic joint infection

The cheapest and best way to avoid complications from prosthetic joint infection is to prevent it. Prevention is controlled both by the surgeon and patient factors.

If you’re considering joint replacement here are four ways to help reduce your risk of infection:

1. Ask your surgeon if they screen patients to determine if they are carriers of staphylococcus

This is a bacteria that commonly causes joint infections. Not all hospital systems perform this simple test. Those patients who are carriers are given an antibiotic ointment to apply to their nose and special medicated wipes to use before surgery. This can decolonize the patient and lessen their risk of infection.

2. Don’t smoke, or if you do, quit before surgery

Patients who use nicotine in any form are at a greater risk of having wound healing problems. Wound healing issues can lead to prosthetic joint infection but people who quit using nicotine prior to surgery can decrease their infection risk.

3. If you have diabetes, control your blood sugar

Another important factor in minimizing infection risk is adequate control of blood sugar for those patients who have diabetes. Diabetes control is often checked with a blood test called hemoglobin A1c, or HbA1c. People whose HbA1c is above seven are at greater risk for prosthetic joint infection. Surgery should be delayed until better diabetes is under better control.

4. Maintain a healthy weight

Finally and most importantly, maintaining a healthy weight can dramatically reduce the risk of prosthetic joint infection. Ideally, a body mass index less than 35 to 40 kg/m2 can be achieved prior to surgery. If a patient’s BMI is over 40 their risk of complications may be up to seven times higher.

“In today’s healthcare environment patients need to take ownership of their health,” Dr. Padubidri emphasizes.

“In order to prepare yourself for surgery and minimize your risks, it’s best to consider losing weight and aggressively managing any medical issues, especially diabetes. You’ll also want to stop smoking. Be sure to ask your surgeon what steps the hospital takes to manage the risk of infection.”

Advertisement

Learn more about our editorial process.

Related Articles

Hand massaging foot with bunion
November 29, 2024/Orthopaedics
Can You Shrink Bunions Naturally?

Wearing shoe inserts, maintaining a healthy weight and using cold or heat therapy may give you relief

Healthcare provider in physical therapy room helping person walk with a walker
November 22, 2024/Orthopaedics
Here’s What Happens After a Knee Replacement

Full recovery takes a year or more, but you’ll likely be walking and driving within a few weeks if you follow your provider’s recovery plan

Bare feet of person standing on exercise mat, with one foot rolling on a roller
November 18, 2024/Orthopaedics
How To Stop Foot Pain From Standing All Day

Try stretching, massage, elevation and a supportive pair of shoes to help relieve foot aches and pains

Large hand with athlete-taped wrist and fingers gripping football on the field
October 16, 2024/Orthopaedics
Understanding the Concussion Protocol, From Little League to the NFL

Concussion protocol describes the steps needed to test for concussion and return to play — timelines vary

Couple raking leaves in their front yard by their house
October 16, 2024/Orthopaedics
Tips To Avoid Back Pain From Raking Leaves

Using proper form and the right equipment can help keep you injury-free while gathering up that colorful foliage

Person outside, grabbing shoulder
September 17, 2024/Orthopaedics
Tendonitis vs. Tendinosis: How Can I Tell the Difference?

Both are forms of tendinopathy, but one is more of an acute injury caused by inflammation, while the other is the result of degeneration over time

Person sitting on couch applying cold compress to arm, with heating pad nearby
September 6, 2024/Orthopaedics
Ice or Heat: What’s Better for Soothing Arthritis Pain?

Both types of therapy work differently, but they can both alleviate symptoms — especially when you alternate methods

Healthcare provider holding X-ray in one hand, pointing to a model of a bone and joint with the other
August 20, 2024/Orthopaedics
What Kind of Doctor Treats Arthritis?

The process usually starts with your primary care provider, who may refer you to a rheumatologist or orthopaedist

Trending Topics

Person touching aching ear, with home remedies floating around
Home Remedies for an Ear Infection: What To Try and What To Avoid

Not all ear infections need antibiotics — cold and warm compresses and changing up your sleep position can help

Infographic of foods high in iron, including shrimp, oysters, peas, cream of wheat, prunes, eggs, broccoli, beef and chicken
52 Foods High In Iron

Pump up your iron intake with foods like tuna, tofu and turkey

Person squeezing half a lemon into a glass of water
Is Starting Your Day With Lemon Water Healthy?

A glass of lemon water in the morning can help with digestion and boost vitamin C levels, and may even help get you into a better routine

Ad