Infections are an extremely serious problem with a high degree of morbidity, particularly             when fracture fixation and joint replacements (implants) are involved. Bacteria are attracted             by implants and colonize their surfaces. Infection destroys bone, prevents fractures from

healing, and causes joint arthroplasty 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 physicans 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 algorithms for treating infections in             hip and knee arthroplasty. These treatment protocols 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 in 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.