At The Ohio State University Wexner Medical Center, our expert team treats patients with two types of musculoskeletal infection: infection of the bone and infection of joint replacements. Left untreated, this type of infection can lead to significant issues or even permanent damage. We are one of only a few programs in the country dedicated to the diagnosis and treatment of bone- and tissue-damaging infection.
Diagnosis of musculoskeletal infection
You’ll undergo a comprehensive physical examination with one of our musculoskeletal infection physicians. During your visit, you and your doctor will talk about your condition, symptoms, medical history and any prior treatments.
Your doctor may order diagnostic tests to help in determining the cause of your infection. These tests may include imaging studies, such as X-rays, magnetic resonance imaging (MRI) or computed tomography (CT) scan, to help your doctor see possible anomalies in your bones, joints and soft tissues.
Your doctor also may order a joint fluid analysis, a test that uses a needle to withdraw a sample of your joint fluid for examination. We may perform blood work including a complete blood count (CBC) to measure your red and white blood cells and hemoglobin and an erythrocyte sedimentation rate (ESR) test and/or C-reactive protein (CRP) test to check for inflammation in the body.
Treatment of musculoskeletal infection
Most patients come to us by referral because they’ve experienced chronic infection lasting days, months or even years that cannot be successfully treated by their primary care or other physician.
Ohio State’s team of orthopedic surgeons, infectious disease specialists, radiologists, researchers, laboratory technicians and nurses specialize in helping patients manage musculoskeletal infection and, when possible, eradicate it. Our team works with you to develop a personalized treatment plan based on your medical condition and our diagnosis of the cause and level of your infection. Your doctor will discuss treatment recommendations with you, most of which include aggressive antibiotic treatment and surgical management such as:
- Explants of hardware. This is the removal of an implanted device. This could include pins, plates or screws from a previous fracture or the joint implant itself, if the infection is related to knee or hip joint replacement. When an implant is removed entirely, your doctor’s first concern is treating or eradicating the infection before determining if you are a candidate for re-implantation.
- Mobile spacers. To treat the infection, your doctor may surgically insert an antibiotic-laden cement spacer. The spacer is a medical grade material that is mixed with antibiotics and then molded to your joint. You can expect it to stay in place for about two to six months, during which time you will be closely monitored by our team. This is necessary to treat and, hopefully, eradicate the infection. Once the infection is gone, your surgeon will remove the spacer. If you’re a candidate for re-implantation, you’ll undergo joint replacement surgery. Depending on your condition, you may undergo re-implantation quickly. Some patients are never re-implanted, due to the nature and level of infection. Your doctor will discuss your options and explain your personalized treatment plan in detail.
- Static spacers. If your infection is very serious, it may take longer to treat it. There is a possibility that your infection may never be completely eradicated. For such serious infection, your doctor may surgically implant a static spacer. A static spacer is essentially a rod with cement and antibiotic packed around the space where the joint implant was previously located. This spacer can remain in place for two or even three years until the infection is gone. Once the infection is gone, you may be eligible for re-implantation. Some patients may never be eligible for re-implantation. If your condition requires advanced reconstruction and additional work with your bone, we may refer you to one of our adult reconstruction specialists for joint replacement.
- Operative irrigation and debridement. This is used when there is a bone infection (not necessarily related to a joint replacement). During this procedure, the physician removes the infected bone area and cleans it out. As part of the infection management strategy, your doctor will pack the area with a medical-grade, synthetic, dissolvable “plaster” that has been mixed with antibiotics. Like mobile and static spacers, this plaster is designed to help eliminate infection.
Finally, as part of our ongoing treatment of musculoskeletal infection, we continually monitor your progress over time. You’ll see your clinical care team and continue to undergo imaging and laboratory testing as a measurement of your progress.
Why choose Ohio State for musculoskeletal infections?
Multidisciplinary Care: Our fellowship-trained orthopedic surgeons work in collaboration with infectious disease specialists and, when necessary, our adult reconstruction surgical team, to give you the best possible outcome.
Surgical Expertise: As one of only a few programs in the country dedicated to the diagnosis and treatment of bone- and tissue-damaging infection, many of our patients are referred to us by physicians from Ohio, Kentucky, Michigan, West Virginia and Pennsylvania.
Orthopaedic Excellence: U.S.News & World Report consistently calls our Orthopaedic program a high-performing specialty in its rankings of top hospitals in central Ohio and across the country.
Research: Our surgical team benefits from the work being done by Ohio State scientists and researchers, including the study of biofilm development. This laboratory work involves studying how bacteria attach to medical implants and could lead to novel treatments. One such project involves testing how certain immunosuppressive-type chemicals can be used to coat medical implants and inhibit bacterial attachment, thereby reducing the possibility of implant-related infection.