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Orthopaedic prosthetic infections

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https://www.readbyqxmd.com/read/29771856/vitamin-e-phosphate-coating-stimulates-bone-deposition-in-implant-related-infections-in-a-rat-model
#1
Arianna B Lovati, Marta Bottagisio, Susanna Maraldi, Martina B Violatto, Monica Bortolin, Elena De Vecchi, Paolo Bigini, Lorenzo Drago, Carlo L Romanò
BACKGROUND: Implant-related infections are associated with impaired bone healing and osseointegration. In vitro antiadhesive and antibacterial properties and in vivo antiinflammatory effects protecting against bone loss of various formulations of vitamin E have been demonstrated in animal models. However, to the best of our knowledge, no in vivo studies have demonstrated the synergistic activity of vitamin E in preventing bacterial adhesion to orthopaedic implants, thus supporting the bone-implant integration...
June 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29628687/megaprosthesis-versus-allograft-prosthesis-composite-for-massive-skeletal-defects
#2
REVIEW
Deepak Gautam, Rajesh Malhotra
Massive skeletal defects are encountered in the setting of tumors necessitating excision, failed total hip arthroplasty with periprosthetic bone loss, periprosthetic fracture, complex trauma, multiple failed osteosynthesis and infection. Reconstruction of the segmental defects poses a tremendous challenge to the orthopaedic surgeons. The goal of osseous reconstruction of these defects is to restore the bone length and function. Currently the most commonly employed methods for reconstruction are either a megaprosthesis or an Allograft Prosthesis Composite (APC)...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29623671/one-and-two-stage-surgical-revision-of-peri-prosthetic-joint-infection-of-the-hip-a-pooled-individual-participant-data-analysis-of-44-cohort-studies
#3
Setor K Kunutsor, Michael R Whitehouse, Ashley W Blom, Tim Board, Peter Kay, B Mike Wroblewski, Valérie Zeller, Szu-Yuan Chen, Pang-Hsin Hsieh, Bassam A Masri, Amir Herman, Jean-Yves Jenny, Ran Schwarzkopf, John-Paul Whittaker, Ben Burston, Ronald Huang, Camilo Restrepo, Javad Parvizi, Sergio Rudelli, Emerson Honda, David E Uip, Guillem Bori, Ernesto Muñoz-Mahamud, Elizabeth Darley, Alba Ribera, Elena Cañas, Javier Cabo, José Cordero-Ampuero, Maria Luisa Sorlí Redó, Simon Strange, Erik Lenguerrand, Rachael Gooberman-Hill, Jason Webb, Alasdair MacGowan, Paul Dieppe, Matthew Wilson, Andrew D Beswick
One-stage and two-stage revision strategies are the two main options for treating established chronic peri-prosthetic joint infection (PJI) of the hip; however, there is uncertainty regarding which is the best treatment option. We aimed to compare the risk of re-infection between the two revision strategies using pooled individual participant data (IPD). Observational cohort studies with PJI of the hip treated exclusively by one- or two-stage revision and reporting re-infection outcomes were retrieved by searching MEDLINE, EMBASE, Web of Science, The Cochrane Library, and the WHO International Clinical Trials Registry Platform; as well as email contact with investigators...
April 5, 2018: European Journal of Epidemiology
https://www.readbyqxmd.com/read/29614037/new-parameters-to-quantitatively-express-the-invasiveness-of-bacterial-strains-from-implant-related-orthopaedic-infections-into-osteoblast-cells
#4
Davide Campoccia, Lucio Montanaro, Stefano Ravaioli, Ilaria Cangini, Francesca Testoni, Livia Visai, Carla Renata Arciola
Complete eradication of bacterial infections is often a challenging task, especially in presence of prosthetic devices. Invasion of non-phagocytic host cells appears to be a critical mechanism of microbial persistence in host tissues. Hidden within host cells, bacteria elude host defences and antibiotic treatments that are intracellularly inactive. The intracellular invasiveness of bacteria is generally measured by conventional gentamicin protection assays. The efficiency of invasion, however, markedly differs across bacterial species and adjustments to the titre of the microbial inocula used in the assays are often needed to enumerate intracellular bacteria...
April 3, 2018: Materials
https://www.readbyqxmd.com/read/29609540/cost-benefit-analysis-of-antibiofilm-microbiological-techniques-for-peri-prosthetic-joint-infection-diagnosis
#5
Carlo L Romanò, Maria Teresa Trentinaglia, Elena De Vecchi, Nicola Logoluso, David A George, Ilaria Morelli, Lorenzo Drago
BACKGROUND: Implant-related infections, including those of peri-prosthetic joint (PJIs), osteosynthesis and other biomaterials, are biofilm-related. Pathogen identification is considered the diagnostic benchmark; however, the presence of bacterial biofilms makes pathogen detection with traditional microbiological techniques only partially effective. To improve microbiological diagnostic accuracy, some biofilm debonding techniques have been recently proposed. Aim of this health economics assessment study was to evaluate their economic impact on hospital costs...
April 2, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29564939/contribution-of-a-multiplex-serological-test-for-the-preoperative-diagnosis-of-prosthetic-joint-infection-a-prospective-study
#6
Camille de Seynes, Bertille de Barbeyrac, Hervé Dutronc, Clément Ribes, Paul Crémer, Véronique Dubois, Thierry Fabre, Michel Dupon, Frédéric-Antoine Dauchy
BACKGROUND: Prosthetic joint infection (PJI) is a severe complication of orthopaedic surgery. Preoperative diagnosis, although sometimes difficult, is key to choose the relevant treatment. METHODS: We conducted a prospective study aimed at evaluating the diagnostic performance of a multiplex serological test for the pre-operative diagnosis of PJI. Blood samples were collected between 1 July 2016 and 31 July 2017 among patients referred for suspected PJI that occurred at least six weeks prior...
March 22, 2018: Infectious Diseases
https://www.readbyqxmd.com/read/29560526/total-ankle-replacement-leads-to-high-revision-rates-in-post-traumatic-end-stage-arthrosis
#7
Yves Gramlich, Oliver Neun, Alexander Klug, Johannes Buckup, Thomas Stein, Arvid Neumann, Sebastian Fischer, Hans-Peter Abt, Reinhard Hoffmann
INTRODUCTION: Extremely heterogeneous revision rates in total ankle arthroplasty (TAA) of the upper ankle joint are reported and result to heterogeneous collectives and to short follow-up times. The aim is to investigate revision rates and the underlying reasons, as well as treatment outcome and quality of life after TAA in post-traumatic cases with sufficient follow-up. METHODS: In 2008-2013, 74 patients with post-traumatic arthrosis were treated using TAA with a Tornier Salto prosthesis, and 60 (35 males and 25 females; mean age 56) were followed-up (mean: 59 months; range 24-91 months)...
March 20, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29555488/assessment-of-theatre-shoe-contamination-in-an-orthopaedic-theatre
#8
K Clesham, P R Ryan, C G Murphy
Prosthetic joint infection (PJI) is a devastating complication of arthroplasty. Numerous protocols reduce potential risk for PJI peri-operatively, but none exist for the management of theatre shoes. Our aim was to assess for bacteria known to cause prosthetic infection on theatre shoes. Forty theatre shoes were analysed; there were coagulase-negative staphylococci on 65% (N = 25), meticillin-susceptible Staphylococcus aureus on 40% (N = 16), and meticillin-resistant S. aureus on 25% (N = 10). Amount of blood spatter correlated poorly with microbial contamination...
March 16, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29554102/the-effect-of-storage-delay-and-storage-temperature-on-orthopaedic-surgical-samples-contaminated-by-staphylococcus-epidermidis
#9
Maïté Van Cauter, Olivier Cornu, Jean-Cyr Yombi, Hector Rodriguez-Villalobos, Ludovic Kaminski
BACKGROUND: Prosthetic Joint Infection (PJI) is a rare but devastating complications with high morbitity and mortality. The identification of the causal microorganism remains crucial and determines therapeutic strategies and success. Microbiology cultures remain the common method to diagnose PJI. Unfortunately, 14% of intra-articular punctures remain negative after culture. The microorganisms are best detected by inoculation of microbiology samples in blood culture bottles (Bactec), or after sonication of the implant and polymerase chain reaction (PCR)...
2018: PloS One
https://www.readbyqxmd.com/read/29470235/is-climate-associated-with-revision-for-prosthetic-joint-infection-after-primary-tka
#10
Ben Parkinson, Drew Armit, Peter McEwen, Michelle Lorimer, Ian A Harris
BACKGROUND: Climate factors have been shown to be associated with spontaneous musculoskeletal and some surgical site infections with increased rates of infection during warmer periods. To date, little research has been performed to determine if this phenomenon is associated with differences in the risk of revision for prosthetic joint infection (PJI) in primary TKA. QUESTIONS/PURPOSES: (1) Does the rate of revision for early PJI within the first year after primary TKA differ between tropical and nontropical regions? (2) Is there a seasonal variation in the rate of revision for PJI? (3) Is the geographic and seasonal variation (if present) associated with the sex, age, and/or American Society of Anesthesiologists (ASA) grade of the patient? METHODS: All 219,983 primary TKAs performed for osteoarthritis over a 5-year period (2011-2015) in the Australian Orthopaedic Association National Joint Replacement Registry were examined based on the month of the primary procedure to determine the rate of revision for PJI within 12 months...
February 21, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29433799/international-survey-among-orthopaedic-trauma-surgeons-lack-of-a-definition-of-fracture-related-infection
#11
M Morgenstern, T F Moriarty, R Kuehl, R G Richards, M A McNally, M H J Verhofstad, O Borens, C Zalavras, M Raschke, S L Kates, W J Metsemakers
INTRODUCTION: Fracture-related infection (FRI) is one of the most challenging musculoskeletal complications in orthopaedic-trauma surgery. Although the orthopaedic community has developed and adopted a consensus definition of prosthetic joint infections (PJI), it still remains unclear how the trauma surgery community defines FRI in daily clinical practice or in performing clinical research studies. The central aim of this study was to survey the opinions of a global network of trauma surgeons on the definitions and criteria they routinely use, and their opinion on the need for a unified definition of FRI...
March 2018: Injury
https://www.readbyqxmd.com/read/29382603/sonication-of-orthopaedic-implants-a-valuable-technique-for-diagnosis-of-prosthetic-joint-infections
#12
Sujeesh Sebastian, Rajesh Malhotra, Vishnubhatla Sreenivas, Arti Kapil, Rama Chaudhry, Benu Dhawan
INTRODUCTION: Accurate and prompt microbiological diagnosis of prosthetic joint infection (PJI) is crucial for successful antimicrobial treatment. Studies have shown the diagnostic utility of sonication of explanted implants in total joint arthroplasty but all did not use consensus statements for defining PJI. We evaluated the diagnostic utility of culture of samples obtained by sonication of explanted implants compared with periprosthetic tissue cultures (PTC) for the diagnosis of PJI using Musculoskeletal Infection Society (MSIS) consensus criteria...
March 2018: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/29368046/current-evidence-does-not-support-systematic-antibiotherapy-prior-to-joint-arthroplasty-in-patients-with-asymptomatic-bacteriuria-a-meta-analysis
#13
Chenglong Wang, Dong Yin, Weifa Shi, Wenwen Huang, Deling Zuo, Qiang Lu
BACKGROUND: Many orthopaedic surgeons worry about asymptomatic bacteriuria (ASB) as a possible risk factor for prosthetic joint infection (PJI). However, available evidence establishing a direct link between ASB and PJI is limited. This meta-analysis aimed to investigate whether ASB is a factor for PJI and whether pre-operative antibiotic treatment shows benefit. METHOD: We systematically searched major databases such as PubMed, Web of Science, the Cochrane Library and EMBASE for studies...
January 24, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29339298/implementation-and-impact-of-an-audit-and-feedback-antimicrobial-stewardship-intervention-in-the-orthopaedics-department-of-a-tertiary-care-hospital-a-controlled-interrupted-time-series-study
#14
Margarida Tavares, Ana Cláudia Carvalho, José Pedro Almeida, Paulo Andrade, Ricardo São Simão, Pedro Soares, Carlos Alves, Rui Pinto, Arnaud Fontanet, Laurence Watier
A prospective audit and feedback antimicrobial stewardship intervention conducted in the Orthopaedics Department of a University Hospital in Portugal was evaluated by comparing an interrupted time series in an intervention group and a non-intervention (control) group. Monthly antibiotic use (except cefazolin) was measured as World Health Organization- and Anatomical Therapeutic Chemical-defined daily doses (DDD) from January 2012 to September 2016, excluding the 6-month phase of intervention implementation starting on January 1, 2015...
January 12, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29212683/-hot-joints-infection-protocol-reduces-unnecessary-post-operative-re-admissions-following-total-hip-and-knee-arthroplasty
#15
J Dattilo, D Gittings, M Sloan, R Charette, E Hume, G-C Lee
AIMS: To evaluate the effectiveness of an institutionally developed algorithm for evaluation and diagnosis of prosthetic joint injection and to determine the impact of this protocol on overall hospital re-admissions.p PATIENTS AND METHODS: We retrospectively evaluated 2685 total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients prior to (1263) and following (1422) the introduction of an infection detection protocol. The protocol used conservative thresholds for C-reactive protein to direct the medical attendant to aspirate the joint...
December 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29139579/topical-adjuvants-incompletely-remove-adherent-staphylococcus-aureus-from-implant-materials
#16
Emily P Ernest, Anthony S Machi, Brock A Karolcik, Paul R LaSala, Matthew J Dietz
Adjuvant treatments including Betadine, Dakin's solution (sodium hypochlorite), or hydrogen peroxide (H2 O2 ) have been attempted to eradicate prosthetic joint infection caused by biofilm or intracellular bacteria. The purpose of this study was to evaluate the in vitro abilities of chemical adjuvants to decrease Staphylococcus aureus (S. aureus) biofilm presence on orthopaedic implant grade materials, including titanium, stainless steel, and cobalt chrome. S. aureus biofilms were grown for 48 h and evaluated for baseline colony forming units/centimeter squared (CFU/cm2 ) and compared to treatments with Betadine, Dakin's solution, H2 O2 , or 1% chlorine dioxide (ClO2 )...
November 15, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29092997/the-orthopaedic-manifestation-and-outcomes-of-methicillin-sensitive-staphylococcus-aureus-septicaemia
#17
D Makki, T Elgamal, P Evans, D Harvey, G Jackson, S Platt
AIMS: The aim of this paper was to present the clinical features of patients with musculoskeletal sources of methicillin-sensitive Staphylococcus aureus (MSSA) septicaemia. PATIENTS AND METHODS: A total of 137 patients presented with MSSA septicaemia between 2012 and 2015. The primary source of infection was musculoskeletal in 48 patients (35%). Musculoskeletal infection was considered the primary source of septicaemia when endocarditis and other obvious sources were excluded...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29067042/a-clinical-study-on-arthroplasty-for-failed-internal-fixation-of-hip-fractures-and-review-of-literature
#18
Feng Mingli, Shen Huiliang, Cao Guanglei, Li Zheng, Lu Shibao, Liu Limin, An Shuai
BACKGROUND & OBJECTIVE: Hip fracture is common osteoporotic fracture associated sometimes with failed internal fixation. Joint replacement is commonly used to salvage failed internal fixation of hip fractures (FIFHF). Our objective was to present the outcome of Arthroplasty after FIFHF in our patients. METHODS: A prospective analysis was made on consecutive patients who underwent prosthetic replacements for FIFHF in Orthopaedics Department of Xuanwu Hospital between June 2012 and January 2015...
July 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28940152/osteomyelitis-risk-in-patients-with-transfemoral-amputations-treated-with-osseointegration-prostheses
#19
Jonatan Tillander, Kerstin Hagberg, Örjan Berlin, Lars Hagberg, Rickard Brånemark
BACKGROUND: Percutaneous anchoring of femoral amputation prostheses using osseointegrating titanium implants has been in use for more than 25 years. The method offers considerable advantages in daily life compared with conventional socket prostheses, however long-term success might be jeopardized by implant-associated infection, especially osteomyelitis, but the long-term risk of this complication is unknown. QUESTIONS/PURPOSES: (1) To quantify the risk of osteomyelitis, (2) to characterize the clinical effect of osteomyelitis (including risk of implant extraction and impairments to function), and (3) to determine whether common patient factors (age, sex, body weight, diabetes, and implant component replacements) are associated with osteomyelitis in patients with transfemoral amputations treated with osseointegrated titanium implants...
December 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28937598/the-effect-of-rankl-opg-balance-on-reducing-implant-complications
#20
REVIEW
Elizabeth R Kapasa, Peter V Giannoudis, Xiaodong Jia, Paul V Hatton, Xuebin B Yang
Despite the phenomenal success of implants particularly in the realms of dentistry and orthopaedics, there are still challenges to overcome. The failure of implants resulting from infection, prosthetic loosening, and non-union continue to be the most notorious examples. The cascade of fracture healing and bone repair, especially with the presence of an implant, is complex because it involves a multifaceted immune response alongside the intricate process of bone formation and remodelling. Bone loss is a serious clinical problem that is frequently accompanied by chronic inflammation, illustrating that there is a convoluted relationship between inflammation and bone erosion...
September 22, 2017: Journal of Functional Biomaterials
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