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Q: femer bone infection in ball, started by a staff infection in hip socket ( Answered 4 out of 5 stars,   0 Comments )
Subject: femer bone infection in ball, started by a staff infection in hip socket
Category: Miscellaneous
Asked by: woody60-ga
List Price: $25.00
Posted: 06 Nov 2006 04:47 PST
Expires: 06 Dec 2006 04:47 PST
Question ID: 780468
what is the proper proceedure if the top of femer ball is infected
caused by  staff infection which is still in hip socket.  Full
replacemet cannot be done until infection of staff is completely gone.
 What is recommended untill full replacement can be done. removal of
ball and replaced with cement? Is it recommended ASAP to prevent
further infection in bone?
Subject: Re: femer bone infection in ball, started by a staff infection in hip socket
Answered By: tutuzdad-ga on 06 Nov 2006 07:30 PST
Rated:4 out of 5 stars
Dear woody60-ga

Thank you for allowing me to answer your interesting question. Please
keep in mind, as our disclaimer points out, that our answers are not
intended to replace professional medical advice. What I am sharing
with you is a matter of published science that is intended to arm you
with valuable information and aid you in further informed discussions
with your medical practitioner.

The condition you are referring to is sometimes called ?septic
arthritis? (infectious arthritis or Pyogenic arthritis) that is
considered relatively uncommon, but not rare. This occurs when a staph
infection is present in the socket of this hip and adversely affects
the normal ball/socket relationship. This type of infection is no
exclusive to any age group and can affect people of any age from
infants to elderly. When a ?staph? (staphylococcus) infection is
present the situation often necessitates urgent medical intervention.
Septic arthritis is considered a medical emergency because of the
damage it can cause to bone and cartilage. With this condition there
is a potential for septic shock, which in turn is a potentially fatal


Since the potential replacement takes a back seat to this more urgent
condition, diagnosis and treatment in adults is much as the same as it
is in children:

?Early diagnosis is important. The infection in the hip joint can
damage the joint and the sooner treatment is started the better. The
history and physical examination are usually enough to make your
doctor highly suspicious of septic hip arthritis. Blood tests help
confirm the diagnosis. A high erythrocyte sedimentation rate (ESR) or
"sed rate" and a white blood count greater than 12,000 are red flags
to suggest inflammation or infection. Sudden onset of symptoms with
fever and positive blood tests all point to septic arthritis.

The doctor will look for signs of swelling, tenderness, and check the
child's range of motion. The spine is also assessed for any problems
that could cause hip pain. X-rays are often ordered. Joint fluid may
be removed with a needle using ultrasound to guide the needle into the
joint. Lab tests on the fluid will identify the exact cause if the
problem is a septic hip.?


?Nonsurgical Treatment
Antibiotic therapy is the first step in treatment. The type of
antibiotic given depends on which bacteria are present. Results are
best if antibiotics are started as soon as possible after the
diagnosis of a joint infection. First, medication is given
intravenously (directly into blood stream) for about seven days and
then orally (pills taken by mouth) for another two or three weeks.

Surgical Treatment 
Surgery is usually required to drain the joint of all infected
material. The joint is thoroughly rinsed with a saline solution. The
goal is to remove any products of inflammation and reduce the number
of bacteria present. Both actions give the antibiotics a better chance
of working quickly. A drain may be placed in the joint for 24 to 48
hours to clear any fluid that has leaked into the nearby tissues. The
surgeon may have to drill into the bone if there is any sign of bone
infection. This procedure helps bring increased blood flow to the area
to clean away bacteria, infection, and dead tissue.?


Obviously a full replacement cannot be done until the infection is
cleared. The recommended course of action is aggressive treatment to
the affected area (ranging from direct site injection of antibiotics
and/or steroids, to surgical draining and cleaning; debridement) in
addition to (in many, but not all cases) systemic treatment (ranging
from oral medications and rest to extended periods of intravenous
antibiotics and steroids). A total hip replacement normally aims at
resurfacing both the cup (acetabulum) and ball (femoral head) surfaces
while a partial hip replacement may consist of only one of these
procedures. However, because the resurfacing of the cup and/or the
application of the prosthetic femoral component is virtually
impossible to do while the surfaces are inflamed or infected, this
naturally requires an infection free environment in order to increase
the probability of a successful revision, therefore such a procedure
is almost universally impossible to perform until the condition has
been defeated. With that said, in the presence of a staph infection
there will likely be no ?removal? or ?replace? of anything WITH
anything until this serious situation is resolved.

The simple answer to your question is that a staphylococcus infection,
no matter where it is found, is a medical emergency, and most urgently
so when found in the bone. The course of treatment should not
necessarily focus on getting the patient ready for pending surgery to
correct a structural deficiency, so much as it should focus (right
now) on saving the patient?s life and limb. Is it recommended ASAP to
prevent further infection in bone? You betcha! Don?t put it off.

I hope you find that my answer exceeds your expectations. If you have
any questions about my research please post a clarification request
prior to rating the answer. Otherwise I welcome your rating and your
final comments and I look forward to working with you again in the
near future. Thank you for bringing your question to us.

Best regards;
Tutuzdad-ga ? Google Answers Researcher







Google ://











Request for Answer Clarification by woody60-ga on 05 Dec 2006 21:49 PST
tutuzdad-ga  thank you for the answer.  It has taken me this long to
answer because I am living through this very situation.  I would love
to tell you the latest that has happened to my husband.  It you are
interested please don't heitate to e mail.  it is very very
ibteresting and even the dieanse Dr. ( avery know one ib Denver is
involded and the most renowned joint replacement clinic in the United
States. Douglas Dennis is very well know in the field for knees and
hips.  But it is a great tale for another time.  Still living it. 
Don't hesitant to write.
Bonnie Wood

P.S.  Would you know  what bacteria they are looking for in a culture
between day 6 to 10.  My husband was on the operating table for a new
hip and they decided he still had a bacteria but nothing is growing
after 5 days.  They put in a spacer and a cement compound taht has
time released antibiotic.  Noe we start the whole process again.

Clarification of Answer by tutuzdad-ga on 06 Dec 2006 12:27 PST
I'm sorry. I wouldn't know. I can only guess that it might be a
staphylococcus or streptococcus infection that is hindering the work.
Some pneumococcal infections such as "streptococcus pneumoniae", that
sometimes affects joints, are somewhat resistent to antibiotics and
must be treated carefully. This might be what's happening but it is
best to meet with the physicians to find out for certain. I'm sure
they would be willing to tell you all about it.

Best of luck;
woody60-ga rated this answer:4 out of 5 stars

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