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Orthopaedic prosthetic infections

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https://www.readbyqxmd.com/read/29139579/topical-adjuvants-incompletely-remove-adherent-staphylococcus-aureus-from-implant-materials
#1
Emily P Ernest, Anthony S Machi, Brock A Karolcik, P Rocco LaSala, Matthew J Dietz
Adjuvant treatments including Betadine, Dakin's solution (sodium hypochlorite), or hydrogen peroxide (H2O2) 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 hours and evaluated for baseline colony forming units/centimeter squared (CFU/cm(2) ) 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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28915961/short-stem-total-hip-arthroplasty-potential-explanations-for-persistent-post-surgical-thigh-pain
#6
Isabel A C Baert, Enrique Lluch, Francis Van Glabbeek, Rudy Nuyts, Salim Rufai, Joanna Tuynman, Filip Struyf, Mira Meeus
Short stem uncemented femoral implants were developed with the aim of preserving proximal bone stock for future revisions, improving biomechanical reconstruction, aiding insertion through smaller incisions and potentially decreasing or limiting the incidence of thigh pain. Despite all the advantages of short stem designs, it remains unclear whether they are able to limit post-surgical thigh pain. In patients with short stem hip arthroplasty and persistent thigh pain, it is of the utmost importance to understand the potential etiologies of this chronic pain for selecting the appropriate treatment strategy...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28860397/diagnosis-of-prosthetic-joint-infection-with-alpha-defensin-using-a-lateral-flow-device-a-multicentre-study
#7
MULTICENTER STUDY
P Berger, M Van Cauter, R Driesen, J Neyt, O Cornu, J Bellemans
AIMS: The purpose of this current multicentre study is to analyse the presence of alpha-defensin proteins in synovial fluid using the Synovasure lateral flow device and to determine its diagnostic reliability and accuracy compared with the prosthetic joint infection (PJI) criteria produced by the Musculoskeletal Infection Society (MSIS). PATIENTS AND METHODS: A cohort of 121 patients comprising 85 total knee arthroplasties and 36 total hip arthroplasties was prospectively evaluated between May 2015 and June 2016 in three different orthopaedic centres...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28809644/-endoprosthesis-infections-guidelines-for-antibiotic-therapy-common-guidelines-of-the-czech-society-for-orthopaedics-and-traumatology-and-the-society-for-infectious-diseases-of-the-czech-medical-association-of-j-e-purkyn%C3%A4
#8
D Musil, M Balejová, M Horníková, A Chrdle, N Mallátová, O Nyč, V Chmelík, J Gallo, D Jahoda, J Stehlík
PURPOSE OF THE STUDY This study aims to articulate regional guidelines for curative and suppressive antibiotic therapy of total joint replacement infections. MATERIAL AND METHODS When developing the standard, used as source materials were the published foreign guidelines for antibiotic therapy of prosthetic joint infections, the analysis of resistance of bacterial strains conducted in the Hospital in České Budějovice, a.s. and the assessment of strain resistance for the Czech Republic published by the European Antimicrobial Resistance Surveillance Network (EARS-Net)...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28759643/in-vitro-comparison-between-%C3%AE-tocopheryl-acetate-and-%C3%AE-tocopheryl-phosphate-against-bacteria-responsible-of-prosthetic-and-joint-infections
#9
COMPARATIVE STUDY
Alessandro Bidossi, Monica Bortolin, Marco Toscano, Elena De Vecchi, Carlo L Romanò, Roberto Mattina, Lorenzo Drago
Biofilm-related infections represent a recurrent problem in the orthopaedic setting. In recent years, great interest was directed towards the identification of novel molecules capable to interfere with pathogens adhesion and biofilm formation on implant surfaces. In this study, two stable forms of α-tocopherol, the hydrophobic acetate ester and the water-soluble phosphate ester, were tested in vitro as coating for titanium prosthesis. Antimicrobial activity against microorganisms responsible of prosthetic and joints infections was assessed by broth microdilution method...
2017: PloS One
https://www.readbyqxmd.com/read/28722231/bacteria-antibiotic-resistance-new-challenges-and-opportunities-for-implant-associated-orthopedic-infections
#10
Bingyun Li, Thomas J Webster
There has been a dramatic increase in the emergence of antibiotic-resistant bacterial strains, which has made antibiotic choices for infection control increasingly limited and more expensive. In the U.S. alone, antibiotic-resistant bacteria cause at least 2 million infections and 23,000 deaths a year resulting in a $55-70 billion per year economic impact. Antibiotics are critical to the success of surgical procedures including orthopedic prosthetic surgeries, and antibiotic resistance is occurring in nearly all bacteria that infect people, including the most common bacteria that cause orthopedic infections, such as Staphylococcus aureus (S...
July 19, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28713108/current-prescribing-practices-for-antibiotic-prophylaxis-a-survey-of-dental-practitioners
#11
Leah S Spittle, Kathleen B Muzzin, Patricia R Campbell, Janice P DeWald, Francisco Rivera-Hidalgo
AIM: Antibiotic prophylaxis guidelines have been developed for health care and dentistry. The authors examined whether dentists were following the 2007 American Heart Association (AHA) and the 2012 American Association of Orthopaedic Surgeons (AAOS) recommendations for antibiotic prophylaxis. MATERIALS AND METHODS: A survey was sent to 600 dentists in the south-central region of the United States. The survey examined dentists' prescribing practices for patients with cardiac and prosthetic joint replacements, antibiotic regimen prescribed, confidence in their prescription decisions, and dentistry's contribution to antibiotic resistance...
July 1, 2017: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/28698316/description-of-the-rates-trends-and-surgical-burden-associated-with-revision-for-prosthetic-joint-infection-following-primary-and-revision-knee-replacements-in-england-and-wales-an-analysis-of-the-national-joint-registry-for-england-wales-northern-ireland-and
#12
Erik Lenguerrand, Michael R Whitehouse, Andrew D Beswick, Andrew D Toms, Martyn L Porter, Ashley W Blom
OBJECTIVES: To describe the prevalence rates of revision surgery for the treatment of prosthetic joint infection (PJI) for patients undergoing knee replacement, their time trends, the cumulative incidence function of revision for PJI and estimate the burden of PJI at health service level. DESIGN: We analysed revision knee replacements performed due to a diagnosis of PJI and the linked index procedures recorded in the National Joint Registry from 2003 to 2014 for England and Wales...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28675248/quick-bacteriophage-mediated-bioluminescence-assay-for-detecting-staphylococcus-spp-in-sonicate-fluid-of-orthopaedic-artificial-joints
#13
Katja Šuster, Aleš Podgornik, Andrej Cör
Staphylococcus spp. accounts for up to two thirds of all microorganisms causing prosthetic joint infections, with Staphylococcus aureus and Staphylococcus epidermidis being the major cause. The present study describes a diagnostic model to detect staphylococci using a specific bacteriophage and bioluminescence detection, exploring the possibility of its use on sonicate fluid of orthopaedic artificial joints. Intracellular adenosine-5'-triphosphate release by bacteriophage mediated lysis of staphylococci was assessed to determine optimal parameters for detection...
July 2017: New Microbiologica
https://www.readbyqxmd.com/read/28630749/imaging-in-peri-prosthetic-assessment-an-orthopaedic-perspective
#14
Christoph H Lohmann, Sanjiv Rampal, Martin Lohrengel, Gurpal Singh
As imaging techniques are ever-evolving, this article aims to provide a brief overview of the various modalities including their limitations. The ability of imaging for evaluation of implant osseo-integration will be addressed and also the role of imaging in assessing septic and aseptic loosening, with a particular focus on adverse tissue reactions, will be discussed. Specific features when imaging the big joints such as shoulder, hip, knee and ankle joint will also be outlined.Overall, a lack of standardisation and validity was noted and despite the gross variety of imaging modalities, there is no technique covering all aspects required for evaluation of implant fixation and septic and aseptic loosening...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28626592/diffuse-b-cell-non-hodgkin-s-lymphoma-presenting-atypically-as-periprosthetic-joint-infection-in-a-total-hip-replacement
#15
Aysha Rajeev, Angela Ralte, Nameer Choudhry, Faizan Jabbar, Paul Banaszkiewicz
The occurrence of extranodal primary B cell non-Hodgkin's lymphoma is rare. Total hip replacement is one of the most common orthopaedic procedures performed. There has been an increased incidence of primary lymphomas involving periprosthetic sites. Chronic inflammation due to metal debris arising from the prosthetic implants has been evidenced as one of the causes for the development of soft tissue lymphomas albeit rarely. We describe a case report of a 77-year-old patient who had underwent a cemented total hip replacement in the past who further developed large B cell primary non-Hodgkin's lymphoma...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28490492/molecular-diagnosis-of-orthopedic-device-related-infection-directly-from-sonication-fluid-by-metagenomic-sequencing
#16
Teresa L Street, Nicholas D Sanderson, Bridget L Atkins, Andrew J Brent, Kevin Cole, Dona Foster, Martin A McNally, Sarah Oakley, Leon Peto, Adrian Taylor, Tim E A Peto, Derrick W Crook, David W Eyre
Culture of multiple periprosthetic tissue samples is the current gold standard for microbiological diagnosis of prosthetic joint infections (PJI). Additional diagnostic information may be obtained through culture of sonication fluid from explants. However, current techniques can have relatively low sensitivity, with prior antimicrobial therapy and infection by fastidious organisms influencing results. We assessed if metagenomic sequencing of total DNA extracts obtained direct from sonication fluid can provide an alternative rapid and sensitive tool for diagnosis of PJI...
August 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28488017/c-reactive-protein-course-during-the-first-5-days-after-total-knee-arthroplasty-cannot-predict-early-prosthetic-joint-infection
#17
Christoph Windisch, Steffen Brodt, Eric Roehner, Georg Matziolis
INTRODUCTION: Periprosthetic joint infection (PJI) is one of the most devastating major complications after total knee arthroplasty (TKA). The laboratory value C-reactive protein (CRP) is the inflammatory biomarker most suitable for detecting a potential postoperative (p.o.) early infection in orthopaedic surgery. However, on the basis of multiple receiver operating characteristic (ROC) analyses, CRP only has limited sensitivity and specificity. The objective of the present study was to test the hypothesis that, besides the absolute preoperative CRP value, also the absolute postoperative CRP value and its course over the first 5 days after TKA are valid indicators of periprosthetic early infection...
May 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28461965/total-knee-arthroplasty-and-infection-how-surgeons-can-reduce-the-risks
#18
REVIEW
Nicola Ratto, Chiara Arrigoni, Federica Rosso, Matteo Bruzzone, Federico Dettoni, Davide Edoardo Bonasia, Roberto Rossi
Total joint arthroplasty (TJA) is one of the most common orthopaedic procedures. Nevertheless, several complications can lead to implant failure.Peri-prosthetic joint infections (PJI) certainly represent a significant challenge in TJA, constituting a major cause of prosthetic revision. The surgeon may have an important role in reducing the PJI rate by limiting the impact of significant risk factors associated to either the patient, the operative environment or the post-operative care.In the pre-operative period, several preventive measures may be adopted to manage reversible medical comorbidities...
September 2016: EFORT open reviews
https://www.readbyqxmd.com/read/28458734/designing-a-new-molecular-probe-the-potential-role-for-tilmanocept-lymphoseek-%C3%A2-in-the-assessment-of-patients-with-painful-hip-and-knee-joint-prostheses
#19
O O Adesanya, C E Hutchinson
BACKGROUND: There is a long history of nuclear medicine developments in orthopaedics beginning in the early 20(th) century. Technetium-99m ((99m)Tc) has a short half-life of six hours, emits 140 keV gamma rays and is the most widely used isotope, imaged with the Anger (gamma) camera. Gamma image quality and test sensitivity in painful prosthetic joints can be improved with single photon emission computed tomography (SPECT) and SPECT/CT. Positron Emission Tomography-Computed Tomography (PET-CT) with Sodium Fluoride ((18)F-NaF) and (18)Fluorine-fluorodeoxyglucose ((18)F-FDG) PET have promising and limited roles respectively in the investigation of painful prosthetic joints...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28403859/managing-uncertainty-a-qualitative-study-of-surgeons-decision-making-for-one-stage-and-two-stage-revision-surgery-for-prosthetic-hip-joint-infection
#20
Andrew J Moore, Ashley W Blom, Michael R Whitehouse, Rachael Gooberman-Hill
BACKGROUND: Approximately 88,000 primary hip replacements are performed in England and Wales each year. Around 1% go on to develop deep prosthetic joint infection. Between one-stage and two-stage revision arthroplasty best treatment options remain unclear. Our aims were to characterise consultant orthopaedic surgeons' decisions about performing either one-stage or two-stage revision surgery for patients with deep prosthetic infection (PJI) after hip arthroplasty, and to identify whether a randomised trial comparing one-stage with two-stage revision would be feasible...
April 12, 2017: BMC Musculoskeletal Disorders
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