Orthopaedics - elective joint replacement

Question 1

VTE prophylaxis after joint replacement guidelines

Answer 1

This involves the option of LMWH for:
28 days post elective hip replacement
14 days post elective knee replacement

Question 2

Risks of joint replacement surgery

Answer 2

Risks with anaesthetic 
Pain
Bleeding 
Infection 
Stiffness/restricted movement in the joint
Joint dislocation
VTE

Question 3

Risk factors for prosthetic joint infections

Answer 3

Prolonged operative time
Obesity
Diabetes

Question 4

What is the most common organism causing prosthetic joint infection?

Answer 4

Staphylococcus aureus

Question 5

Diagnosis and management of prosthetic joint infection

Answer 5

Diagnosis involves a combination of clinical findings, x-rays, blood tests (raised inflammatory markers), cultures (e.g., blood or synovial fluid) and findings during further operations.

Management involves repeat surgery and prolonged antibiotics (over months). Surgery may involve joint irrigation, debridement or complete replacement.