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Orthopaedic prosthetic infections

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https://www.readbyqxmd.com/read/28490492/molecular-diagnosis-of-orthopaedic-device-infection-direct-from-sonication-fluid-by-metagenomic-sequencing
#1
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 sonication fluid culture of 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...
May 10, 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
#2
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
#3
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 Rev
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28393758/prosthetic-joint-and-implant-contamination-caused-by-ralstonia-pickettii-a-report-of-three-cases%C3%B9
#6
Brett D Edwards, Ranjani Somayaji, Bayan Missaghi, Wilson W Chan, Aaron J Bois
We describe three cases of orthopaedic contamination caused by Ralstonia pickettii grown from prosthetic joint and implant material cultures following sonication in the microbiology laboratory. Given the temporal association between the cases, lack of clinical or intra-operative features of infection, growth of the organism in the water bath, and unlikely etiology of Ralstonia as a prosthetic joint or implant pathogen, the bacteria were judged to be contaminants.
2017: SICOT-J
https://www.readbyqxmd.com/read/28332761/a-uk-national-survey-of-care-pathways-and-support-offered-to-patients-receiving-revision-surgery-for-prosthetic-joint-infection-in-the-highest-volume-nhs-orthopaedic-centres
#7
Andrew J Moore, Michael R Whitehouse, Rachael Gooberman-Hill, Jason Heddington, Andrew D Beswick, Ashley W Blom, Tim J Peters
BACKGROUND: Deep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long-term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients. AIM: This survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement...
March 23, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28326413/antibiotic-prophylaxis-for-dental-treatment-after-prosthetic-joint-replacement-exploring-the-orthopaedic-surgeon-s-opinion
#8
Clare M McNally, Renuka Visvanathan, Sharon Liberali, Robert J Adams
BACKGROUND: Antibiotic prophylaxis before dental treatment is routinely recommended by orthopaedic surgeons to prevent prosthetic joint infection (PJI). This recommendation is at odds with current guidelines. METHODS: A postal survey of 9 checkbox or short-answer questions was completed by 633 orthopaedic surgeons. RESULTS: The majority of respondents (n = 186 of 260, 72%) believe that antibiotic prophylaxis is required indefinitely for dental treatment...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28321490/c-reactive-protein-may-misdiagnose-prosthetic-joint-infections-particularly-chronic-and-low-grade-infections
#9
Daniel Pérez-Prieto, María E Portillo, Lluís Puig-Verdié, Albert Alier, Santos Martínez, Lluisa Sorlí, Juan P Horcajada, Joan C Monllau
BACKGROUND: Periprosthetic tissue cultures, sonication and synovial fluid cultures remain the gold standard for prosthetic joint infection (PJI) diagnosis. However, some 15-20% culture-negative PJI are still reported. Therefore, there is the need for other diagnostic criteria. One point of concern relative to the different definitions of PJI is as to the inclusion of the c-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) as diagnostic criteria for PJI despite them being non-specific inflammatory blood tests...
March 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28218379/the-corail-stem-as-a-reverse-hybrid-survivorship-and-x-ray-analysis-at-10-years
#10
Helge Wangen, Lars Nordsletten, Jens G Boldt, Anne M Fenstad, David E Beverland
BACKGROUND: The use of a cemented cup together with an uncemented stem in total hip arthroplasty (THA) has become popular in Norway and Sweden during the last decade. The results of this prosthetic concept, reverse hybrid THA have been sparsely described.We report our experience of reverse hybrid THA, using the Elite plus polyethylene cemented cup together with the Corail fully hydroxyapatite-coated uncemented stem and a 28-mm alumina ceramic head. PATIENTS AND METHODS: 132 consecutive reverse hybrid hip arthroplasties were performed from January 2000 to December 2003 in 126 patients with a mean age of 54...
February 7, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28196029/twelve-year-outcomes-of-an-oxinium-total-knee-replacement-compared-with-the-same-cobalt-chromium-design-an-analysis-of-17-577-prostheses-from-the-australian-orthopaedic-association-national-joint-replacement-registry
#11
Christopher J Vertullo, Peter L Lewis, Stephen Graves, Lan Kelly, Michelle Lorimer, Peter Myers
BACKGROUND: Oxidized zirconium (Oxinium) was introduced as an alternative bearing surface to cobalt-chromium (CoCr) in an attempt to reduce polyethylene wear and decrease aseptic mechanical failure of total knee replacements. While noncomparative reports have been described as promising, we were aware of no short or long-term clinical studies showing the superiority of Oxinium on polyethylene as a bearing surface. Using data from a comprehensive national joint replacement registry, we compared the long-term outcomes after cruciate-retaining total knee arthroplasty (TKA) with an Oxinium femoral component and those with the same prosthetic design but with a CoCr femoral component...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28194715/does-extracellular-dna-production-vary-in-staphylococcal-biofilms-isolated-from-infected-implants-versus-controls
#12
Beata Zatorska, Marion Groger, Doris Moser, Magda Diab-Elschahawi, Luigi Segagni Lusignani, Elisabeth Presterl
BACKGROUND: Prosthetic implant infections caused by Staphylococcus aureus and epidermidis are major challenges for early diagnosis and treatment owing to biofilm formation on the implant surface. Extracellular DNA (eDNA) is actively excreted from bacterial cells in biofilms, contributing to biofilm stability, and may offer promise in the detection or treatment of such infections. QUESTIONS/PURPOSES: (1) Does DNA structure change during biofilm formation? (2) Are there time-dependent differences in eDNA production during biofilm formation? (3) Is there differential eDNA production between clinical and control Staphylococcal isolates? (4) Is eDNA production correlated to biofilm thickness? METHODS: We investigated eDNA presence during biofilm formation in 60 clinical and 30 control isolates of S aureus and S epidermidis...
February 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28074257/outcomes-of-dual-mobility-cups-in-a-young-middle-eastern-population-and-its-influence-on-life-style
#13
Chahine Assi, Elie El-Najjar, Camille Samaha, Kaissar Yammine
Dual mobility cups (DMC) in total hip arthroplasty (THA) are becoming popular among orthopaedic surgeons. Substantial benefit of their use has been reported among high risk patients, particularly in reducing post-operative hip instability (dislocation). Many reports stated some concern when implanted in young and active people where complications such as polyethylene wear and mechanical loosening could potentially be higher. This Middle Eastern study analyses a retrospective series of THA for any aetiology other than infection, using DMC for the acetabular component in 75 patients (85 implants) less than 70 years old...
March 2017: International Orthopaedics
https://www.readbyqxmd.com/read/27942968/false-positive-cultures-after-native-knee-aspiration-true-or-false
#14
Jason M Jennings, Douglas A Dennis, Raymond H Kim, Todd M Miner, Charlie C Yang, David C McNabb
BACKGROUND: Synovial fluid aspiration is a routine practice used by most orthopaedic surgeons to aid in the diagnosis of joint infection. In patients for whom there is a low pretest probability of infection, a positive culture-particularly if it is a broth-only culture-may be considered a contaminant, especially if the bacterial species are skin pathogens. To our knowledge no study has evaluated the incidence of contamination of aspirations from the native knee. QUESTIONS/PURPOSES: What is the frequency of false-positive cultures among knee aspirations of the native knee? METHODS: Two hundred patients, with a total of 200 knees, with the diagnosis of degenerative osteoarthritis undergoing a total knee arthroplasty (TKA) were identified for this study...
December 9, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27941556/preclinical-evaluation-of-photoacoustic-imaging-as-a-novel-noninvasive-approach-to-detect-an-orthopaedic-implant-infection
#15
Yu Wang, John M Thompson, Alyssa G Ashbaugh, Pavlo Khodakivskyi, Ghyslain Budin, Riccardo Sinisi, Andrew Heinmiller, Marleen van Oosten, Jan Maarten van Dijl, Gooitzen M van Dam, Kevin P Francis, Nicholas M Bernthal, Elena A Dubikovskaya, Lloyd S Miller
INTRODUCTION: Diagnosing prosthetic joint infection (PJI) poses significant challenges, and current modalities are fraught with low sensitivity and/or potential morbidity. Photoacoustic imaging (PAI) is a novel ultrasound-based modality with potential for diagnosing PJI safely and noninvasively. MATERIALS: In an established preclinical mouse model of bioluminescent Staphylococcus aureus PJI, fluorescent indocyanine green (ICG) was conjugated to β-cyclodextrin (CDX-ICG) or teicoplanin (Teic-ICG) and injected intravenously for 1 week postoperatively...
February 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27897182/design-and-development-of-novel-antibacterial-ti-ni-cu-shape-memory-alloys-for-biomedical-application
#16
H F Li, K J Qiu, F Y Zhou, L Li, Y F Zheng
In the case of medical implants, foreign materials are preferential sites for bacterial adhesion and microbial contamination, which can lead to the development of prosthetic infections. Commercially biomedical TiNi shape memory alloys are the most commonly used materials for permanent implants in contact with bone and dental, and the prevention of infections of TiNi biomedical shape memory alloys in clinical cases is therefore a crucial challenge for orthopaedic and dental surgeons. In the present study, copper has been chosen as the alloying element for design and development novel ternary biomedical Ti‒Ni‒Cu shape memory alloys with antibacterial properties...
November 29, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27869495/a-comparison-of-airborne-bacterial-fallout-between-orthopaedic-and-vascular-surgery
#17
COMPARATIVE STUDY
P Stather, M Salji, S-U Hassan, M Abbas, A Ahmed, H Mills, T Elston, C Backhouse, A Howard, S Choksy
INTRODUCTION The objective of the study was to compare bacterial fallout during vascular prosthesis insertion and orthopaedic major joint replacement performed in conventional and laminar flow ventilation, respectively. MATERIALS AND METHODS A prospective single-centre case control study of 21 consecutive elective vascular procedures involving prosthetic graft insertion and 24 consecutive elective orthopaedic major joint replacements were tested for degree of bacterial fallout using agar settle plates. Preparation time, waiting time and total procedure duration were collected at the time of surgery, and bacterial colony counts on the agar settle plates from airborne bacterial fallout were counted after an incubation period...
April 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27815925/microbiological-diagnosis-of-implant-related-infections-scientific-evidence-and-cost-benefit-analysis-of-routine-antibiofilm-processing
#18
Lorenzo Drago, Elena De Vecchi
Prosthetic joint infection is one of the most severe complication following joint arthroplasty, producing a significant worsening of patient's quality of life. Management of PJIs requires extended courses of antimicrobial therapy, multiple surgical interventions and prolonged hospital stay, with a consequent economic burden, which is thought to markedly increase in the next years due to the expected burden in total joint arthroplasties. The present review summarizes the present knowledge on microbiological diagnosis of prosthetic joint infections, focusing on aethiological agents and discussing pros and cons of the available strategies for their diagnosis...
November 5, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27680718/staphylococcus-capitis-isolated-from-prosthetic-joint-infections
#19
S Tevell, B Hellmark, Å Nilsdotter-Augustinsson, B Söderquist
Further knowledge about the clinical and microbiological characteristics of prosthetic joint infections (PJIs) caused by different coagulase-negative staphylococci (CoNS) may facilitate interpretation of microbiological findings and improve treatment algorithms. Staphylococcus capitis is a CoNS with documented potential for both human disease and nosocomial spread. As data on orthopaedic infections are scarce, our aim was to describe the clinical and microbiological characteristics of PJIs caused by S. capitis...
January 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27677890/review-of-knee-arthroscopic-practice-and-coding-at-a-major-metropolitan-centre
#20
James P Lisik, Michelle M Dowsey, Joshua Petterwood, Peter F M Choong
BACKGROUND: Arthroscopic knee surgery has been a topic of significant controversy in recent orthopaedic literature. Multiple studies have used administrative (Victorian Admitted Episodes Dataset and Centre for Health Record Linkage) data to identify trends in practice. This study explored the usage and reporting of arthroscopic knee surgery by conducting a detailed audit at a major Victorian public hospital. METHODS: A database of orthopaedic procedures at St Vincent's Hospital Melbourne was used to retrospectively identify cases of knee arthroscopy from 1 December 2011 to 1 April 2014...
May 2017: ANZ Journal of Surgery
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