[Text on screen: Ohio State Health & Discovery
What causes periprosthetic joint infections?]

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[Text on screen: Douglas Chonko, DO
Orthopedic Surgeon
Ohio State Wexner Medical Center]

Douglas Chonko, DO:
Periprosthetic joint infections are typically caused at the time of the initial surgery. The majority of infections, probably in the range of 60 to 70%, are a result of the patient being open and the organisms have access to the inner part of the body and to the joint replacement. 

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We see these typically in the first year of that joint replacement, but we also see infections that are hematogenous, which means they have spread through the blood, and those are typically infections that develop after a year. Infections that develop after a year are introduced through the bloodstream and oftentimes they're from other parts of the body. They can be from an infection anywhere in the body. To give you examples, I have infections that will come from a bad foot abscess, diabetic foot ulcers. I have a patient that was bitten while on vacation in Central America by an unknown spider that developed a large abscess to his chest and that went to his hip replacement.

So they can come from multiple different areas, something as simple as scratching your finger. We've got evidence that even brushing your teeth releases bacteria into your bloodstream. If that bacteria then travels to your hip or your knee replacement, it can take residence there and start to grow and oftentimes then becomes a problem and we call that a PJI. As far as the toothbrush, there was a real good study where they had people rinse with a radioactive substance and then had people brush their teeth. They had a monitor right above the heart and they would see these radioactive-labeled bacteria passing through the heart while people were brushing their teeth. So people that should take a little extra care are people that have bleeding gums, people that have really bad cavities and haven't been to the dentist in a long period of time and any other infection of the mouth, whether it's in the gums or it's a deepened bone infection, which some people develop. 

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You want to get that taken care of because the bacteria do enter the bloodstream and can travel to a hip and a knee replacement.

[Text on screen: Ohio State Health & Discovery
For more information, visit:
wexnermedical.osu.edu/orthopedics]

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