At The Ohio State University Wexner Medical Center, our nationally recognized team of musculoskeletal specialists help people with disabling, chronic, sometimes unexplained pain caused by two types of musculoskeletal infection: infection of the bone and infection of joint replacements. It’s important to get timely treatment for these types of infection.
One of only a few programs in the country dedicated to the diagnosis and treatment of bone- and tissue-damaging infection, Ohio State’s team of orthopedic surgeons, infectious diseases specialists, radiologists, researchers, laboratory technicians and nurses specializes in helping you manage musculoskeletal infection and, when possible, eliminate it.
What you can expect
Diagnosis of musculoskeletal infection
Our musculoskeletal infection physicians will perform a comprehensive physical examination on you and talk with you about your condition, symptoms, medical history and any prior treatments.
We may order diagnostic tests to help determine the cause of the infection. These tests help to see possible abnormalities in bones, joints and soft tissues: X-rays, magnetic resonance imaging (MRI) and computed tomography (CT) scan.
We might also order a joint fluid analysis, a test that uses a needle to withdraw a sample of your joint fluid for examination. The fluid in your joints can tell us the exact problem causing your pain and inflammation.
We may also perform blood work, including a complete blood count to measure red and white blood cells and hemoglobin, and an erythrocyte sedimentation rate test and C-reactive protein test to check for inflammation in the body.
Treatment options for musculoskeletal infection
Most patients come to us by referral because they’ve experienced chronic infection lasting days, months or even years that can’t be successfully treated by their primary care or other physician.
Your Ohio State doctor will discuss treatment recommendations with you, which may 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, our doctor’s first concern is treating or eliminating the infection before determining if you’re a candidate for re-implantation.
- Mobile spacers. To treat the infection, we might surgically insert an antibiotic-filled cement spacer. The spacer is a medical-grade material that’s mixed with antibiotics and then molded to the joint. It likely will stay in place for two to six months, during which time we’ll closely monitor you. Once the infection is gone, a surgeon will remove the spacer. If re-implantation is an option, joint replacement surgery will happen next. Depending on your overall 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 options and explain personalized treatment plans in detail.
- Static spacers. If your infection is very serious, it may take longer to treat it. For some infections, there’s a possibility that it may never be completely cleared up. Such serious infections may require surgically implanting a static spacer, which 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. At that time, re-implantation could be an option. Some patients may never be eligible for re-implantation. If your condition requires advanced reconstruction and additional work with the bone, we may refer you to one of our adult reconstruction specialists for joint replacement.
- Operative irrigation and debridement. This is used when there’s 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, we will pack the area with a medical-grade, synthetic, dissolvable “plaster” that’s 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 infection?
Multidisciplinary care: Our fellowship-trained orthopedic surgeons work in collaboration with infectious diseases specialists, and with our adult reconstruction surgical team when necessary, to provide patients with the best possible outcome.
Surgical expertise: We’re 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 around Ohio and the surrounding states.
Orthopedic excellence: U.S. News & World Report consistently names our Orthopaedic program a high-performing specialty in its rankings of Best Hospitals.
Research: Our surgical team benefits from the work being done by Ohio State scientists and researchers. One example is the study of biofilm development, which involves learning how bacteria attach to medical implants. Another project involves testing how certain immunosuppressive-type chemicals can be used to coat medical implants and discourage bacterial attachment, reducing the possibility of implant-related infection.
How we treat Orthopedic Infections
Caring for Osteomyelitis
If you need mobility help
If you need home medical equipment, such as a walker or a wheelchair, it’s easy to obtain quickly through Ohio State Home Medical Equipment (OSHME), a joint venture between Ohio State Health Inc. and DASCO Home Medical Equipment. OSHME has staff and supplies on hand for patients of The Ohio State University Wexner Medical Center. To learn more about available equipment, place an order or talk to an equipment specialist, visit godasco.com.