AB132. 125. Antibiotic therapy in the initial 6-week period following total knee arthroplasty

Background: Little is known about the interaction between post-operative knee arthroplasty patients and other healthcare professionals prior to 6-week orthopaedic review. The aim of this study was to identify patients treated in the community for infection in this early post-operative period. The secondary aim of this study was to survey contact between patients and non-orthopaedic healthcare professionals prior to their 6-week review.

Methods: Patients who had undergone total knee replacement (TKR) in 2016/2017 were surveyed at their 6-week outpatient appointment. Basic demographics, doctor visits, physiotherapy, imaging investigations, antibiotic therapy and indication were documented.

Results: Fifty-six patients underwent TKR. Forty-two patients visited their GP in the 6-week period and one patient presented to the emergency department. Twenty-six point seven percent (n=15) patients commenced antibiotic therapy without orthopaedic input. The most common indication was wound infection (n=10, 17.8%), followed by urinary tract infection (n=3, 5.35%) and respiratory tract infection (n=1, 1.78%). Two patients (3.57%) were unsure of the indication. Two patients (3.57%) underwent imaging investigations. Two (3.57%) patients did not receive physiotherapy follow-up.

Conclusions: A significant proportion of TKR patients are being treated with antibiotic therapy without input from orthopaedic services. This highlights the need for improved communication between general practitioners (GPs) and orthopaedic services, as well as clearer discharge instructions. This suggests a possible role for rapid access orthopaedic clinics if there is any concern regarding post-operative wound infection. The majority of knee arthroplasty patients receive appropriate post-operative physiotherapy input.

Keywords: Antibiotic; treatment; postoperative; knee; arthroplasty