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.