Infections are an extremely serious problem, particularly when fracture fixation and joint             replacement implants are involved. Fortunately joint replacement infection is very low             (<1%), but broken bones that pierce the skin can have rates as high as 30%. Bacteria are

attracted by implants and colonize their surfaces. Infection destroys bone, prevents             fractures from healing, and causes joint replacement components to loosen. In addition,

there is evidence that the presence of an implant affects the immune system and its             ability to fight off an infection.             The orthopaedic and infectious disease physicians collaborating with our laboratory are in             the national and international forefront of the treatment of musculoskeletal infection. The             Musculoskeletal Sepsis Unit of Hennepin County Medical Center, directed by Dr. Dean             Tsukayama, is a multistate referral center for orthopaedic infection. Drs. Tsukayama,             Gustilo and Kyle have developed widely accepted methods for treating infections in hip             and knee replacements. These treatments have been successfully implemented around the             world. Work is currently being done to determine if oral antibiotics, with their associated             significant reduction in hospital stay and health care costs, are as successful clinically as             the more expensive intravenous antibiotics. Our collaborating physicians are involved in             clinical trials of new orthopaedic–related antibiotics on an ongoing basis.             This wide–ranging clinical activity is coupled with extensive laboratory research. A number             of biochemical studies have been conducted to determine how the presence of an implant             affects the immune system, rendering it less effective in combating an infection. Antibiotic–             impregnated beads, capable of being implanted in an infection site, have been developed,             tested and marketed.