Abstract
Between 1987 and 1993 we have treated 62 pyogenic infection cases, 28 with osteomyelitis and 34 with arthritis. There were also 13 MRSA (methicillin resistant Staph. aureus) joint infections in 9 cases. The total MRSA infection rate in bone and joint infections was 15%, the numbers of the affected hips, knee and MP joints being 5, 5, and 3, respectively. Three knee joints which had received intra-articular corticosteroid injection were treated with synovectomy and continuous irrigation, and 2 cases in association with a biomaterial (internal fixation devices and joint replacements) were treated by removal of the device and continuous closed irrigation. Two hip joints with prosthesisrelated infections showed prolonged infection and 3 others were referable to an internal fixation device. The treatments used to reduce the infection were removal of the prosthesis with continuous closed irrigation or antibiotic impregnated cement beads. Infection engrafted on a biomaterial responded poorly to antibiotic therapy and was not cured until the internal fixation device or joint replacement had been removed.
