Question:My husband had a total shoulder replacement that didn't go well. First he had a blood clot after the operation. Now he has an infection in the joint. How do they treat the infection when the blood clot hasn't dissolved completely?
Answer:Sometimes joint infection after surgery requires a procedure called debridement. The surgeon goes back into the joint and cleans it out. In the case of someone who is being treated for an embolus (clot), another operation may have to be delayed.
Some surgeons advise treating infection first with antibiotics before performing surgery. Patients who have had surgery to treat infection often have a lower functional level after the operation. Usually a six week's course of antibiotic therapy is required.
Studies show the results are better when this course of action is followed. In your husband's situation, the six weeks' time may be all that's needed to completely resolve the embolus. If the infection doesn't clear up, then the implant may have to be removed and replaced.Joshua S. Dines, MD, et al. Outcomes Analysis of Revision Total Shoulder Replacement. In The Journal of Bone and Joint Surgery. July 2006. Vol. 88-A. No. 7. Pp. 1494-1500.
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