Re: Staph Infections - A Question....

February 22, 2004

Hi Lois,

Some of the MDs on this site might have better answers for this, but it

seems to me that the incidence of Staph infections is probably related to

the degree of invasiveness of the THR surgery. Cutting off the top of the

femur, reaming out the shaft, and pounding in a spike would seem to me to

present a wide-open door to the development of an infection, compared to the

smaller amount of bone remodeling and shallower core removed to accomodate

the femoral cap in a resurfacing. What do the docs think?

P.

Staph Infections - A Question....

> I was at a party last night for a friends 50th birthday. There

> were many people I hadn't seen in a long time. Many of them knew I

> was going to have hip replacement surgery and quite a few of them

> knew it had something to do with an FDA trial. Well, seeing me

> walking around well and happy, lots of folks asked me about the

> surgery and how it was different then THR.

>

> At one point I was talking to 4 people. Two of the people chimed

> in that close relations (one had a 50 year old sister and another a

> 84 year old mother) had recently had THR. BOTH people said their

> relations developed Staph (sp?) Infections in the hospital. Both

> women had to have massive antibiotics applied into the surgical

> opening and both had to have the device removed. One woman (the

> younger) will have had 6 operations by time she is finished, the

> other had 4. Both will have recouperations that entail inablity to

> get out of bed, massive drugs, repeated surgeries and of course the

> ensuing depression over such a terrible thing.

>

> We have 1200 people that come to this site to post. In the 1 1/2

> years I have been here, I do not remember reading any posts about

> Staph infections. Is there something about a THR that makes a

> person more open to this type of infection? Is a Resurfer less at

> risk for this? Any thoughts?

>

> Lois C+ 3/27/03 Dr. Mont

>

February 22, 2004

Hi Lois,

Staph infections are a hazzard of any adventure in a hospital.............

Everyones chances are governed by a number of factors,

1. Your own personal health situation, personal luck etc. This plays a far

bigger role than most of us realise/accept.

2. The record of the hospital - this is pretty critical as it appears some

manage to keep Staph infections at bay better than others.

My OS would only do my surgery in a certain hospital as he said it gave

the best odds for me not getting a

Staph infection, given we thought we were facing a 6 hr op pre op.

3. How long the operation lasts - which is one reason surgeons are

continually trying to shorten the op time. I was facing a potential

6 hr op and my OS said that was really hunting on the edge of high

probabilities of Staph infections regardless of what precautions were

taken. He managed to get it done in 3 hrs 20 mins which obviously

improved to my odds dramatically.

4. Just how much is done during the operation and the complication of it.

Like you, I would think that simply reaming the top of a femur

and fitting a cap would be lessening potential odds when compared to

doing some slicing, digging and placing shafts down bone

marrow. However, I suspect the record of the hospital op theatre/OS

procedures probably plays more of a role than this.

5. Touching the bones in any way also introduces the possibility of

Osteomylitis - which starts as an infection in the bone marrow. It is

different to Staph which will just occur anywhere and the bug has to

be lurking in the body preop. Again the less done to the bone

obviously the better and one reason why a Resurface was considered

better for me than a THR, as I had a history of Osteomylitis.

i.e. the last thing I needed was interference with bone marrow.

It is sad to hear of anyone having such horrors over a simple hip

replacement but these things do happen in a variety of

operations.............. and yet another reason why you will often see the

folks on Totallyhip list recommending that a good surgeon is the critical

factor in getting a good result. Put simply good surgeons with good

reputations do not operate in hospital theatres that don't have a good

reputation for cleanliness and low Staph infection rates. With a Resurface I

would think that doctors selected for trials in US would have been top rate

and so by inference more likely to only operate in good hospitals.

Edith LBHR Dr L Walter Syd Aust 8/02