ABSTRACT
Inflammation and infection are large topics to cover in terms of the essentials required for day-to-day orthopaedic practice. This chapter covers an in-depth knowledge of acute osteomyelitis and septic arthritis. The five cardinal features of acute inflammation are rubor (erythema), calor (heat), dolor (pain), tumour (swelling) and functio laesa (loss of function). Acute inflammation follows a specific sequence. A generalized state of inflammation evolves, known as the systemic inflammatory response syndrome (SIRS). Microorganisms that can cause infection include bacteria, viruses, parasites and fungi. Bacteria are designated gram-positive or gram-negative depending on whether the cell membrane of the bacterium retains crystal violet indium dye after an alcohol rinse. A feature common to both osteomyelitis and prosthetic infections is the provision of a surface that facilitates bacterial attachment, subsequent biofilm formation and an established infection. Treatment strategies to prevent biofilm formation include the local delivery of antibiotic impregnated cement and derivatization of implant surfaces with antibiotics.
