Bone and Joint Infections

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Joint infections, also defined as septic arthritis, are one of the most common orthopedic diseases which require immediate treatment. The disease will not be explained here because it is not one of the targetted subjects in our webpage. The development and treatment of septic arthritis in the neighboring of prosthesis has been explained in details in ‘prosthesis infection’ section. Therefore, only a general information will be given about bone infections in this section.

Osteomyelitis is the medical term used to define the bone and bone marrow infections. The microorganism staphylococcus aures is the most common pathogene for osteomyelitis and it is called ‘nonspecific bone infection’. The infections caused by tuberculosis, fungi and brucella(prevalent among cheese producers ) are defined as ‘specific bone infections’.

The diagnosis and treatment of osteomyelitis is categorised in two groups as acute(early) and chronic(late). Acute osteomyelitis generally develops with the settlement of bacteria which are transported by blood circulation in the neighboring of bone after trauma and the bacteria damage the region. Generally, the children are the patient group and the symptoms in hospital admittance are fever, inability to walk and inability to move the arm. Surgery is performed after the diagnosis is verified with blood tests(leukecyte, CRP and sedimentation counts) and bacterial puncture. The treatment consists of opening the affected region, discharge of infection and bacterial cleaning. Acute osteomyelitis will recover with the use of proper antibiotics after surgery without leaving any sequale. Chronic osteomyelitis is a more challenging bone infection the orthopedicians must deal with.

Chronic osteomyelitis, which was considered as an untreatable condition about 20 years ago, can be treated now in about 70-80% by using the new treatment and reconstruction principles introduced by Dr.Cierny. The treatment of each case may not be possible. The succes rate will be low particulary among elderly and patients with poor immune system, and who had used cortisone and oncologic treatment for long time, patients with tuberculosis history and among smokers. Dr. Cieryn suggests that chronic osteomyelitis can be treated with adequate drainage of germs(removal of regional tumor tissue if required) and then with the complete eradication of infection with antibiotic chains and sticks. Healthy and functional limb can be gained after providing a healthy bone by reconstruction of bone loss and limb shortness using Ilizarov principles.