NYU Langone orthopedic surgeons may recommend surgery for some people with bone or joint infections. Treatment depends on the type and location of the infection.
Doctors may recommend a procedure called debridement to remove dead or damaged bone tissue in people with osteomyelitis. During this procedure, the doctor cuts away dead or damaged bone tissue. He or she also washes the wound to remove any dead or loose tissue.
Doctors may eventually replace the removed bone with a graft, a small piece of bone taken from your hip or from a bone bank, a facility that stores donated bone tissue. During this procedure, the doctor may implant antibiotics directly into the bone.
A skin graft may also be needed if the skin around the bone or joint is infected and doesn’t heal. In a skin graft, an NYU Langone plastic surgeon removes the infected skin and replaces it with healthy skin or muscle into the area. Doctors usually take a patch of skin from the buttocks, inner thigh, or another part of the body. The healthy skin is anchored into place with staples or a few small stitches.
Sometimes, the surgeon also moves some muscle to cover an area around a bone or joint infection. This can promote healing, because the muscle provides healthy blood flow to the bone or joint. Surgeons can often perform skin and muscle grafts at the same time as debridement.
If the infection is deep within the body or a bone is being removed, your doctor may give you general anesthesia before the procedure. If the infection is closer to the surface, he or she numbs the area around the wound with a regional or local anesthetic. You may be given a sedative to help you relax during the procedure.
It can be difficult to completely eliminate osteomyelitis, which can become a chronic infection. Some people may need multiple surgeries to completely remove the damaged or dead bone.
For people with septic arthritis, doctors may first remove the infected joint fluid before deciding if surgery is necessary. The doctor often withdraws the infected fluid with a needle inserted into the joint.
Draining may be performed daily over the course of several days or weeks, until the infection is cleared. Some joints, such as the hip, are more difficult to drain with a needle, so you may need surgery.
If a joint implant becomes infected, you may need surgery to remove the prosthetic device and the surrounding infected tissue. An orthopaedic surgeon may replace the device with a temporary antibiotic spacer to manage the infection. This spacer is left in place for a few months while the body heals and the infection is eliminated. Doctors then perform a second surgery to implant a new prosthetic joint.
Infected joints may be treated with a minimally invasive arthroscopic procedure or open surgery, which is called arthrotomy. With either approach, doctors remove the infected lining of the joint, in a procedure called synovectomy, and wash the area with fluid to decrease the amount of bacteria there.
After surgery, IV antibiotics are required for several months to prevent the infection from returning.
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