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https://www.readbyqxmd.com/read/29224989/synovial-calprotectin-an-inexpensive-biomarker-to-exclude-a-chronic-prosthetic-joint-infection
#1
Marjan Wouthuyzen-Bakker, Joris J W Ploegmakers, Karsten Ottink, Greetje A Kampinga, Lucie Wagenmakers-Huizenga, Paul C Jutte, Anneke C M Kobold
BACKGROUND: To diagnose or exclude a chronic prosthetic joint infection (PJI) can be a clinical challenge. Therefore, sensitive and specific biomarkers are needed in the diagnostic work-up. Calprotectin is a protein with antimicrobial properties and is released by activated neutrophils, making it a specific marker for infection. Because of its low costs and ability to obtain a quantitative value as a point of care test, it is an attractive marker to use in clinical practice. In addition, the test is already used in routine care in most hospitals for other indications and therefore easy to implement...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29221840/a-multicenter-study-of-irrigation-and-debridement-in-total-knee-arthroplasty-periprosthetic-joint-infection-treatment-failure-is-high
#2
Kenneth L Urish, Andrew G Bullock, Alexander M Kreger, Neel B Shah, Kwonho Jeong, Scott D Rothenberger
BACKGROUND: In total knee arthroplasty (TKA) periprosthetic joint infection (PJI), irrigation and debridement (I&D) with component retention is a treatment option with a wide variation in reported failure rates. The purpose of this study was to determine failure rates, outcomes, and factors that predict failure in I&D for TKA PJI. METHODS: A multicenter observational study of patients with a TKA PJI and subsequently undergoing an I&D with retention of components was conducted...
November 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29218685/patient-reported-quality-of-life-and-hip-function-after-2-stage-revision-of-chronic-periprosthetic-hip-joint-infection-a-cross-sectional-study
#3
Ninna R Poulsen, Inger Mechlenburg, Kjeld Søballe, Jeppe Lange
INTRODUCTION: Very limited information is available regarding patient-reported health-related quality of life (HRQoL) and hip function following treatment for chronic periprosthetic hip joint infection (PJI). Patient-reported outcome measures provide essential information to clinicians of the impact a treatment have on patient's lives. The purpose of this study was to examine patient reported HRQoL and hip function after a completed re-implantation in a 2-stage revision. METHOD: 82 patients were identified retrospectively in the National Patient Register...
December 4, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29193440/mid-term-outcomes-and-complications-of-total-knee-arthroplasty-in-haemophilic-arthropathy-a-review-of-consecutive-131-knees-between-2006-and-2015-in-a-single-institute
#4
S J Song, J K Bae, C H Park, M C Yoo, D K Bae, K I Kim
INTRODUCTION: Although total knee arthroplasty (TKA) in haemophilic arthropathy can reduce severe joint pain and improve functional disability, it is technically demanding. AIM: To evaluate mid-term outcomes and complications of TKA in haemophilic arthropathy. METHODS: This study retrospectively reviewed 131 consecutive primary TKAs in a single institute. The mean age was 41.0 years old, and the mean follow-up period was 6.8 years. Clinical and radiographic results were evaluated...
November 29, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29191466/synovial-fluid-multiplex-pcr-is-superior-to-culture-for-detection-of-low-virulent-pathogens-causing-periprosthetic-joint-infection
#5
Christian Morgenstern, Sabrina Cabric, Carsten Perka, Andrej Trampuz, Nora Renz
INTRODUCTION: Analysis of joint aspirate is the standard preoperative investigation for diagnosis of periprosthetic joint infection (PJI). We compared the diagnostic performance of culture and multiplex polymerase chain reaction (PCR) of synovial fluid for diagnosis of PJI. PATIENTS AND METHODS: Patients in whom aspiration of the prosthetic hip or knee joint was performed before revision arthroplasty were prospectively included. The performance of synovial fluid culture and multiplex PCR was compared by McNemar's chi-squared test...
November 2, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29188677/scanning-electron-3d-confocal-and-stereotactic-microscopies-morpho-structural-analysis-of-antibiotic-loaded-cement-porosity-in-three-different-formulations
#6
D Fenga, G Vermiglio, F Traina, A Favaloro, M A Rosa
Chronic osteoarticular infections such as osteomyelitis or periprosthetic joint infection (PJI) have become a growing problem over the years. The “gold standard” in local antibiotic administration is still the antibiotic-loaded acrylic bone cement (ALABC) which is used in both prophylaxis, because it has been shown it can reduce the risk of infection and used in therapy during a “two-stage surgery” in PJI or in chronic osteomyelitis. We performed morphological analysis of three different formulations of antibiotic-loaded cement (ALABC) using techniques of light microscopy, scanning electron microscopy (SEM) and 3D immunofluorescence, in order to explain how the morphological aspects of cement could influence and modulate antibiotic elution...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29188173/influence-of-sonication-on-bacterial-regrowth-from-antibiotic-loaded-pmma-scaffolds-an-in-vitro-study
#7
Martin Clauss, Esther Laschkolnig, Susanne Graf, Klaus-Dieter Kühn
Periprosthetic joint infection (PJI) is one of the most challenging complications after joint replacement. However, when treated correctly, chances of recovery are good. The most important step in correct diagnosis and management of PJI is the detection of the causative germ. In the last years, the use of sonication in the diagnostic process has become more important. However, this diagnostic methodology has been controversially discussed when used in combination with antibiotic loaded bone cement (PMMA), which is frequently used in joint replacement surgeries...
2017: Journal of Bone and Joint Infection
https://www.readbyqxmd.com/read/29187163/daptomycin-treatment-in-patients-with-resistant-staphylococcal-periprosthetic-joint-infection
#8
Yu-Jui Chang, Mel S Lee, Chen-Hsiang Lee, Po-Chun Lin, Feng-Chih Kuo
BACKGROUND: Resistant staphylococcal organisms remain a serious problem in the treatment of periprosthetic joint infection (PJI). Higher failure rates have been reported when vancomycin was used. The purpose of this study was to assess the clinical dosage, effect, and safety of daptomycin in patients with resistant staphylococcal PJI. METHODS: We retrospectively enrolled patients with hip or knee PJI who were treated with daptomycin in our institution (n = 16) from January 2013 to December 2014 with a minimum follow-up of 2 years...
November 29, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29181355/group-b-streptococcal-prosthetic-knee-joint-infection-linked-to-the-consumption-of-raw-fish
#9
Gin Way Law, Limin Wijaya, Andrew Hwee Chye Tan
Introduction: Group B Streptococcal (GBS) prosthetic joint infections (PJI) are rare, accounting for only 4.6-6% of primary and revision total knee replacements (TKRs). In 2015, there was an outbreak of GBS infections in Singapore with an association confirmed between consumption of Chinese-style raw fish dishes (snakehead fish, Asian bighead carp) and GBS infection, Type III GBS ST283 strain, affecting more than 200 patients in Singapore. This outbreak is the largest of its kind in the world and also the first time that foodborne transmission of GBS has been proven...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29178982/microbiology-and-associated-risk-factors-in-alloplastic-total-joint-infections-a-20-year-retrospective-study
#10
Rhae Riegel, Kevin Sweeney, Gino Inverso, Peter Quinn, Eric J Granquist
PURPOSE: Prosthetic joint infection (PJI) is a rare complication of temporomandibular joint replacement (TJR). This study evaluated TJR PJIs at the authors' institution over a 20-year period, including micro-organisms cultured, antibiotic resistance patterns, and intraoperative protocols of TJR. PATIENTS AND METHODS: Patients were identified using Current Procedural Terminology and International Classification of Diseases, Ninth Revision codes and surgical logs from January 1995 through 2015...
November 8, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29176504/screening-for-infection-before-revision-hip-arthroplasty-a-meta-analysis-of-likelihood-ratios-of-erythrocyte-sedimentation-rate-and-serum-c-reactive-protein-levels
#11
Elina Huerfano, Maria Bautista, Manuel Huerfano, Guillermo Bonilla, Adolfo Llinas
INTRODUCTION: Diagnosing periprosthetic joint infection (PJI) before revision hip arthroplasty is critical to ensure effective treatment of patients undergoing surgery for reasons other than infection. The main objective of our study is to determine whether the erythrocyte sedimentation rate (ESR) and the serum C-reactive protein (CRP) level are sufficient to use for testing to rule out infection in patients undergoing revision hip surgery. METHODS: We performed a systematic review of the literature in the MEDLINE, Ovid, and Embase databases...
December 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29174761/vancomycin-povidone-iodine-protocol-improves-survivorship-of-periprosthetic-joint-infection-treated-with-irrigation-and-debridement
#12
Aldo M Riesgo, Brian K Park, Christina P Herrero, Stephen Yu, Ran Schwarzkopf, Richard Iorio
BACKGROUND: Irrigation and debridement with modular component and liner exchange (IDLE) is a low morbidity procedure for treatment of periprosthetic joint infection (PJI) with reported failure rates exceeding 50%. Dilute povidone-iodine lavage has been shown to be safe and effective in decreasing acute PJI in primary total joint arthroplasty. Vancomycin powder has also shown to be effective in preventing infection in spine surgery. We hypothesize that a vancomycin povidone-iodine protocol (VIP) used in conjunction with IDLE can increase infection-free survivorship after acute PJI...
October 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29174023/antibiotic-treatment-of-asymptomatic-bacteriuria-prior-to-hip-and-knee-arthroplasty-a-systematic-review-of-the-literature
#13
REVIEW
Alistair I W Mayne, Peter S E Davies, James M Simpson
BACKGROUND: There is significant debate as to whether routine antibiotic treatment of asymptomatic bacteriuria (ASB) in arthroplasty patients reduces the risk of subsequent PJI. No previous systematic reviews have been undertaken on this subject. The aim of this systematic review was to investigate whether antibiotic treatment of asymptomatic bacteriuria in arthroplasty patients reduces the risk of prosthetic joint infection and to investigate whether the organisms cultured in peri-operative urine samples are the same as those responsible for subsequent prosthetic joint infections...
November 21, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29171826/tertiary-care-centre-adherence-to-unified-guidelines-for-management-of-periprosthetic-joint-infections-a-gap-analysis
#14
Mitchel D Armstrong, Alberto V Carli, Hesham Abdelbary, Stephane Poitras, Peter Lapner, Paule E Beaule
BACKGROUND: The success rate of surgical treatment for periprosthetic joint infection (PJI) remains inconsistent in the literature. Variability in PJI clinical guidelines and surgeon adherence to guidelines could affect treatment success. The objectives of this study were to appraise current recommendations for PJI management and develop a unified clinical standard of care, to perform a gap analysis of PJI cases in a tertiary institution to determine the rate of guideline adherence, and to determine if adherence to unified PJI guidelines affected 2-year treatment outcomes...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29141925/unusual-salmonella-typhi-periprosthetic-joint-infection-involving-bilateral-knees-management-options-and-literature-review
#15
Ashok Rajgopal, Inayat Panda, Anu Gupta
A 70-year-old Indian woman, who had undergone primary bilateral total knee arthroplasty (TKA) for rheumatoid arthritis 10 months prior, presented with 10 days history of pain, swelling and erythema over both knees with pus discharging from the right knee. She had type 2 diabetes mellitus and was on long-term steroid, leflunomide and antitumour necrosis factor therapy for rheumatoid arthritis. Her clinical and laboratory features were suggestive of a haematogenous periprosthetic joint infection (PJI). The final diagnosis of bilateral Salmonella typhi PJI was made based on culture reports...
November 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29139571/human-prosthetic-joint-infections-are-associated-with-myeloid-derived-suppressor-cells-mdscs-implications-for-infection-persistence
#16
Cortney E Heim, Debbie Vidlak, Jessica Odvody, Curtis W Hartman, Kevin L Garvin, Tammy Kielian
Prosthetic joint infection (PJI) is a devastating complication of joint arthroplasty surgery typified by biofilm formation. Currently, mechanisms whereby biofilms persist and evade immune-mediated clearance in immune competent patients remain largely ill-defined. Therefore, the current study characterized leukocyte infiltrates and inflammatory mediator expression in tissues from patients with PJI compared to aseptic loosening. CD33(+) HLA-DR(-) CD66b(+) CD14(-/low) granulocytic myeloid-derived suppressor cells (G-MDSCs) were the predominant leukocyte population at sites of human PJI compared to aseptic tissues...
November 15, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29130112/infection-risk-assessment-in-patients-undergoing-primary-total-knee-arthroplasty
#17
Lazaros A Poultsides, Georgios K Triantafyllopoulos, Vasileios I Sakellariou, Stavros G Memtsoudis, Thomas P Sculco
PURPOSE: To determine the incidence and to identify potential risk factors for in-hospital and late infections, as well as for deep periprosthetic joint infection (PJI) following TKA. METHODS: We identified 17,959 patients treated with primary TKA between 2000 and 2009. We recorded patient demographics, comorbidities and in-hospital complications. The rates of in-hospital, late, and deep PJIs were determined. Different logistic regression models were built to identify risk factors for each of the above types of infection...
November 12, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29129616/risk-of-periprosthetic-joint-infection-in-patients-with-multiple-arthroplasties
#18
W Parker Abblitt, Emily W Chan, Andrew A Shinar
BACKGROUND: Risk of subsequent periprosthetic joint infection (PJI) in a second prosthetic joint following initial PJI has been shown to be 19%-20%. We sought to identify (1) the risk of developing a second PJI for our patients with multiple prosthetic joints and (2) the effect of bacteremia on development of a subsequent PJI. METHODS: We retrospectively reviewed all patients treated surgically for PJI by a single surgeon from 2003 to 2014. Time between initial and subsequent infection, bacteremia, and risk factors for PJI were identified...
November 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29122410/non-compliance-with-idsa-guidelines-for-patients-presenting-with-methicillin-susceptible-staphylococcus-aureus-prosthetic-joint-infection-is-a-risk-factor-for-treatment-failure
#19
A Bouaziz, I Uçkay, S Lustig, A Boibieux, D Lew, P Hoffmeyer, P Neyret, C Chidiac, T Ferry
OBJECTIVE: The long-term impact of treatment strategies proposed by the IDSA guidelines for patients presenting with methicillin-susceptible S. aureus (MSSA) prosthetic joint infection (PJI) is not well-known. PATIENTS AND METHODS: Retrospective (2000-2010) cohort study including patients presenting with MSSA hip or knee PJI. A univariate Cox analysis was performed to determine if the non-compliance with IDSA surgical guidelines was a risk factor for treatment failure...
November 6, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29119076/are-there-benefits-in-early-diagnosis-of-prosthetic-joint-infection-with-multiplex-polymerase-chain-reaction
#20
Christian Lausmann, Akos Zahar, Mustafa Citak, Julian Brañes, Stefan Schmidl, Lars Frommelt, Thorsten Gehrke, Matthias Gebauer
Purpose Identification of bacteria and susceptibility are fundamental in periprosthetic joint infection (PJI). Especially in the case of systemic inflammatory response syndrome (SIRS) rapid detection of pathogens is essential for proper therapy. Bacterial cultures are time consuming. The polymerase chain reaction (PCR) is a non-culture molecular method and is able to rapidly identify pathogens and their resistance genes. Multiplex PCR (mPCR) can amplify several different DNA sequences simultaneously. The aim of this study was to show the value of mPCR for early diagnosis of PJI...
2017: Journal of Bone and Joint Infection
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