Surgery Stall

Posted Sat, 01/30/10

Surprise, surprise…

My hip replacement surgery has been delayed again, this time due to an infected tooth. This is the third obstacle to the procedure. Although I'm very frustrated by it all, I'm also grateful that the doctor is looking out for me. I'm due to have some dental work next week, after which I will be on antibiotics for about two weeks before the surgery can be rescheduled.

Infection after hip replacement is serious business.

According to About.Com:

Why do joint replacement infections cause problems? Bacteria are usually well controlled by our immune system. Once an infection is detected, our immune system rapidly responds, and attacks the infecting bacteria. However, implanted materials, like those found in a joint replacement, can allow infections to persist. Our immune system is unable to attack bacteria that live on these implants, and these infections can become serious problems. If an infection of an implant goes untreated, the problem can worsen, and the bacteria can gain such a foothold that they can become a systemic problem.


What happens when a total joint replacement becomes infected? When a total joint replacement becomes infected, it may loosen, become painful, and need to be removed. Unfortunately, even if the implant is washed clean during surgery, most types of infections require removal of the implant to cure the infection.

Once an implant is removed for an infection, can a new one be put back in? Yes, but not until the infection is cleared. Your orthopedic surgeon, in consult with a infectious disease specialist will determine the optimal treatment schedule, and obtain periodic blood work studies to determine when the infection is likely cured. After that time, a revision replacement (replacement of a joint replacement) may be considered.

As for future dental work:

After the operation, the risk of developing an infection from an outside source is reduced, but there is still a risk of developing an infection from the blood stream. Because of this, patients with a joint replacement implant should take antibiotics before invasive procedures such as dental work, colonoscopies, etc. It is known that these procedures may cause a transient risk of bacteria entering the blood stream. Antibiotics will help control this and prevent joint infection.

Something else I wouldn't be too happy about:

Late infections, usually occurring months or years after the joint replacement surgery, almost always require removal of the implant, placement of an "antibiotic spacer," and IV antibiotics. Patients who undergo this surgery will need at least 6 weeks of IV antibiotics, possibly more, before a new joint replacement can be put back in the joint.

Note: Information (C) Dr. Jonathan Cluett.

Considering the horrific conditions I might find myself in with an infection occurring after surgery, I'm content with being "better safe than sorry." It's bizarre to think one little tooth is holding up the show, but there you have it.

More hip replacement goodies can be found here.