Review of Lyme in Prosthetic Joint Infections

This article summarizes a review of the literature regarding reported cases of prosthetic joint infections (PJI) caused by Lyme in knee replacements. The goal of the review was to initiate the development of a treatment strategy for these infections.

Investigators found only five cases of Lyme PJI in the literature after searching Scopus and PubMed published reports of cases of PJIs secondary to Lyme disease. All cases were from patients residing in the northeastern region of the US. All patients were successfully treated, 4 with surgical intervention and postoperative antibiotics and one with intravenous and oral antibiotics for 6 weeks, without surgical intervention. 

In all patient cases reviewed, synovial fluid Lyme polymerase chain reaction and serological tests were positive, and at the conclusion of treatment all patients were asymptomatic. 

Authors recommend practitioners in endemic regions highly consider Lyme disease infections in cases of PJI that are culture-negative. Authors further suggest that additional research is needed to clearly define an effective treatment regimen for these patients. 

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