Author/Editor		Militarov, Anže; Gubina, Marija; Smrke, Dragica
Title		Okužbe umetnih sklepov
Translated title		Prosthetic joint infections
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 45, št. 3
Publication year		2006
Volume		str. 253-61
Language		slo
Abstract		Demographic trends and advances in surgery have led to an increase in treatment of prosthetic joints in the developed world. Orthopedic replacement surgery has revolutionized medicine with various joint implants and has thus provided millions of people with mobility and a life free of pain. Prosthetic joint infections are relatively rare, however, they are the most severe complication and account for a substantial proportion of health care expenditures. Pathogens causing the infection of implants typically grow in biofilms that protect the microorganisms against the host's immune defences and antibiotics. It is therefore imperative to promptly and accurately recognise, diagnose and treat prosthetic joint infections. Despite the rapid development of various diagnostic techniques such as diagnostic imaging, microbiological, biomolecular diagnostics and others, modern diagnostics for prosthetic joint infection are not always straightforward and current laboratory methods still depend on isolation of a pathogen by culture from synovial fluid or periprosthetic tissue. Successful treatment of prosthetic joint infections requires antimicrobial therapy in combination with surgical treatment including necrectomy, drainage, local antibiotic treatment or even removal of the prosthesis and re-implantation. Combined, antimicrobial and surgical treatment regimens are predominantly effective.
Summary		Zaradi demografskih trendov in napredka v kirurgiji se zdravljenje z umetnimi sklepi v razvitem svetu povečuje. Ortopedska protetika s sklepnimi protezami omogoča neštetim bolnikom mobilnost in življenje brez bolečin ter tako korenito spreminja sodobno medicino. Okužbe umetnih sklepov so relativno redke, vendar predstavljajo najhujši zaplet tovrstnega zdravljenja in predstavljajo velik delež zdravstvenih izdatkov. Raznovrstni mikrobi, ki povzročajo vnetja vsadkov, rastejo v biofilmu, ki mikroorganizme ščiti pred antibiotiki in imunskim sistemom gostitelja. Zaradi tega je pomembno kar se da hitro in natančno prepoznati ter zdraviti okužbe umetnih sklepov. Kljub hitremu razvoju raznovrstnih slikovnih, mikrobioloških, molekularno-bioloških in drugih diagnostičnih metod moderna diagnostika okužb umetnih sklepov ni vedno enostavna in tudi danes temelji na osamitvi povzročitelja iz sinovialne tekočine ali obproteznega tkiva v kulturi. Okužbe vsadkov zahtevajo poleg antimikrobnega, tudi kirurško zdravljenje z nekrektomijo, spiranjem, drenažo, lokalnimi antibiotiki in odstranitvijo ali zamenjavo proteze. Rezultati kombiniranega, antimikrobnega in kirurškega zdravljenja, so v veliki večini dobri.
Descriptors		PROSTHESIS-RELATED INFECTIONS JOINT PROSTHESIS BIOFILMS