Brucella infection following total joint arthroplasty: A systematic review of the literature.

INTRODUCTION

The aim of this systematic review was to analyze the results of published treatment options in Brucella infection following total joint arthroplasty (TJA).

METHODS

We performed a systematic review of the literature regarding outcomes of Brucella infection after TJA (hip and knee). We searched multiple databases for articles in the area published from 1950 to 2016.

RESULTS

A total of 18 patients (12 male and 6 female; mean age 59 years) from 14 published studies were identified. The minimum follow-up time was 6 months (range, 6-120 months). Seven patients were treated with debridement or antibrucella treatment only. Eleven patients (61%) underwent removal of the prosthesis and were treated with one or two-stage exchange arthroplasty. The mean duration of antibiotic therapy was 5.8 months. There was no relapse of infection.

CONCLUSIONS

In the absence of loosening of the components of the prosthesis, an attempt to treat Brucella infection medically might be a reasonable choice. One or two-stage exchange arthroplasty could provide successful results without relapse of infection when combined with appropriate antibiotherapy.

LEVEL OF EVIDENCE: Level III, therapeutic study.