Today we would like to share the preventative approach that Equilae takes towards knee surgery infections, as well as the development of a new technique that has allowed us to completely eliminate the risk of infection after anterior cruciate ligament reconstruction.
The newspaper La Vanguardia covered this story:
Degenerative knee injuries (arthrosis or joint wear and tear) can greatly affect quality of life by causing pain and getting in the way of everyday activities. On the other hand, knee ligament injuries (of which ACL injuries are the most well known) make regular athletic activity impossible, which also negatively impacts active individuals.
At Equilae, when we operate on a patient due to a degenerative injury or a knee ligament injury, the goal is to restore their quality of life and athletic ability. Patient satisfaction is our mission.
However, complications can occur that slow down this return to normalcy, such as post-surgical infections. Recovery can be made even more difficult if an infection is not treated properly. Below, we first explain prosthetic infections (occurring after total knee replacement surgery) and then ligament surgery infections (occurring after anterior cruciate ligament reconstruction, ACLR).
Infection after total knee replacement surgery
The average rate of knee replacement surgery infection in Europe is about 2.5-3%. Equilae has managed to reduce this rate to 1.5%. This has been achieved through the implementation of various measures:
- Bacterial decolonisation prior to surgery: through the utilisation of antiseptic agents in the days leading up to surgery, it is possible to reduce the possibility of bacteria being present on the patient’s skin, which can lead to infection.
- Optimisation of antibiotic prophylaxis: when a prosthesis is implanted, antibiotics are always administered before performing the surgery. This results in a reduced risk of infection. In addition, at Equilae this prophylaxis is adapted to the risk factors of each patient (obesity, previous antibiotic treatments, rheumatic diseases, etc.), according to the most recent studies on the subject.
- Use of antibiotic-loaded cement: biological cements are used in order to anchor the knee prosthesis to the bone (both the femur and the tibia). These cements can be loaded with antibiotics, making them an effective method according to the prosthesis records of Scandinavian countries.
What happens if the knee replacement prosthesis becomes infected despite these measures?
Fortunately, the Equilae team is accustomed to managing prosthetic infections; we belong to prestigious European organisations dedicated to studying this subject (e.g. ESSKA and the Pro-Implant Foundation).
The most important part of managing an infection after total knee replacement surgery is the diagnosis, since these infections often only cause pain, and are not accompanied by the symptoms that indicate infection to patients and many professionals: pus, fever, etc. This lack of knowledge can have serious consequences, because if the infection is not diagnosed, it will not be properly treated. Therefore, when presented with a patient who has been experiencing pain after a total knee replacement, it is crucial to rule out the possibility that this pain is due to a prosthetic infection. This type of infection, which only presents itself as pain, is known as a low-grade infection, since the bacteria are able to infiltrate the prosthesis and form a biofilm that prevents antibiotics from working. For this reason, if a total knee replacement prosthetic infection is diagnosed, it is necessary to perform surgery while antibiotics are being administered.
Infections after anterior cruciate ligament reconstruction (ACLR)
This type of infection is fairly less common than that of total knee prosthesis, but it is equally important. European records indicate a rate of infection between 1 and 2%. In recent years, Equilae has managed to reduce the rate of ACLR infections to 0. This has been achieved through the implementation of a technique developed together with Australian researchers. The technique consists of immersing the ACL plasty (the new ligament that will be implanted to replace the broken ligament) in a vancomycin solution. This practice has been endorsed by several scientific studies and has allowed Equilae to join the prestigious ACL Study Group, as well as to participate in scientific research conventions with renowned hospitals like Berlin’s Charité. These partnerships have enhanced our knowledge of the origin, prevention and treatment of ACLR infections.
Ultimately, it is a matter of employing measures aimed at reducing the risk of infection, and optimising treatment in order to improve the patient’s quality of life.