TY - JOUR T1 - The management of prosthetic joint infection in the community: a guide for general practice JF - British Journal of General Practice JO - Br J Gen Pract SP - 88 LP - 90 DO - 10.3399/bjgp17X689329 VL - 67 IS - 655 AU - Babundo Okwechime AU - Oluwarantimi Ayodele AU - Oliver James Pearce Y1 - 2017/02/01 UR - http://bjgp.org/content/67/655/88.abstract N2 - More than 180 000 hip and knee joint replacements are performed annually in the UK,1 and this number will rise with an increasing ageing population. Hip and knee replacements are largely considered successful in terms of patient-reported outcome measures, survivorship, and low complication rates. However, even a 1% average infection rate after prosthetic replacement represents an increasing burden to the NHS.2Infected prostheses can present early or late3 and the treatment for each differs. As a general rule the acute (early) infections are much more clinically apparent than the ‘never been right’ chronic infection.Early infectionsDefined as occurring less than 3 months post-surgery,3 these tend to present with cellulitis and symptoms of sepsis. The wound may have discharged since the time of surgery or after the wound had healed initially. A persistent serous, haemo-serous, or purulent discharge may indicate infection. The knee is tender and swollen, with evidence of inflammation. As swelling, tenderness, pain, and minor serous wound discharge can be normal early after knee replacement, this may pose a diagnostic challenge in differentiating normal from infected.Late infectionsDefined as occurring more than 3 months post-surgery,3 late infections present more insidiously (Figure 1). The patients often report the knee has ‘never been right’ or that their preoperative arthritic … ER -