Take steps to prevent prosthetic joint infections
People often wonder how old is too old for to have a joint replacement surgery. Patients are often surprised by the answer there is no absolute age limit on who and at what age can safely undergo joint replacement.
The decision making process involves matching the benefits of surgery versus the risks. Even in cases when a person is into their 90s, the benefits may outweigh the risks. Surprisingly enough, young patients are not always appropriate candidates for surgery simply because of factors that are mostly under the patient’s control.
These factors may increase the risk of a devastating complication of total joint arthroplasty called prosthetic joint infection. Prosthetic joint infection occurs in 0.5 to 2.5 percent of joint replacements in the United States, depending on the hospital system and is rather costly.
It is a tremendous economic burden to any hospital system, but also represents a long, painful experience for the patient
4 ways to help prevent infection
The cheapest way to cure prosthetic joint infections is to prevent these infections in the first place. Prevention is controlled both by surgeon and patient factors. If a person is considering joint replacement, these four pieces of adv ice can help reduce the risk of infection:
- Talk to your surgeon to check if they screen patients to determine if they are carriers of staphylococcus (a bacteria that commonly causes joint infections. The patients who are carriers are given an antibiotic ointment to apply to their nose and special medicated wipes to use before surgery. This helps decolonize the patient and lessen their risk of infection.
- Avoid smoking, 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 infections, and infection risk is decrease in patients who quit using nicotine prior to surgery.
- Control your blood sugar if you have diabetes. Another important factor in minimizing infection risk is adequate control of blood sugar for those patients who are diabetic. Diabetic control is checked with a blood test called Hemoglobin A1c, or HbA1c. Those patients whose HbA1c is above 7 are at greater risk of PJI, and surgery should be delayed until better diabetes control can be obtained.
- Keep a healthy weight. Finally, and probably most importantly, maintaining a healthy weight can dramatically reduce the risk of an 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.
Patients In today’s health care environment need to take ownership of their health. In order to prepare for surgery and minimize the risks, consider losing weight, aggressively managing any medical issues – especially diabetes, stop smoking and get informed about what steps the hospital takes to manage the risk of prosthetic joint infections.