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How can surgery or a penetrating injury increase the risk of septic arthritis?

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Septic arthritis occurs when microorganisms, typically bacteria, infiltrate the joint space and cause acute inflammation. While the most common route for these pathogens is through the circulatory system following a bloodstream infection, surgery and penetrating injuries provide a direct pathway for bacteria to enter the joint.12

When a joint is breached during surgery or by a penetrating trauma, the natural barriers that protect the sterile joint environment are compromised. This allows bacteria present on the skin or in the surrounding environment to be introduced directly into the joint space, where they can multiply and trigger an infection. The presence of a prosthetic joint further increases this risk, as foreign materials can provide a surface for bacteria to colonize. Because articular cartilages have limited regenerative capacity, such infections require prompt medical intervention to prevent permanent joint damage.21