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https://www.readbyqxmd.com/read/29052797/suppressive-antibiotic-therapy-with-oral-tetracyclines-for-prosthetic-joint-infections-a-retrospective-study-of-78-patients
#1
M Pradier, O Robineau, A Boucher, M Titecat, N Blondiaux, M Valette, C Loïez, E Beltrand, S Nguyen, H Dézeque, H Migaud, Eric Senneville
PURPOSE: This study aimed at describing the use of oral cyclines (i.e., doxycycline and minocycline) as suppressive antibiotic therapy (SAT) in patients with periprosthetic joint infections (PJIs). METHODS: Medical charts of all patients with surgical revisions for PJIs who were given cycline-based SAT because of a high failure of various origins were reviewed. Data regarding tolerability and effectiveness of cycline-based SAT were analysed. RESULTS: Seventy-eight patients of mean age 64 ± 17 years received cycline-base SAT in the period from January 2006 to January 2014...
October 20, 2017: Infection
https://www.readbyqxmd.com/read/29040138/vitamin-d-supplementation-a-low-risk-high-gain-therapy-to-prevent-pji-commentary-on-an-article-by-vishal-hegde-md-et-al-single-dose-preoperative-vitamin-d-supplementation-decreases-infection-in-a-mouse-model-of-periprosthetic-joint-infection
#2
https://www.readbyqxmd.com/read/29040128/single-dose-preoperative-vitamin-d-supplementation-decreases-infection-in-a-mouse-model-of-periprosthetic-joint-infection
#3
Vishal Hegde, Erik M Dworsky, Alexandra I Stavrakis, Amanda H Loftin, Stephen D Zoller, Howard Y Park, Sherif Richman, Daniel Johansen, Yan Hu, Julie A Taylor, Christopher D Hamad, Rene F Chun, Weixian Xi, John S Adams, Nicholas M Bernthal
BACKGROUND: Despite recent advances, infection remains the most common etiology of arthroplasty failure. Recent work suggests that 25-hydroxyvitamin D (25D) deficiency correlates with the frequency of periprosthetic joint infection (PJI). We endeavored to examine whether 25D3 deficiency leads to increased bacterial burden in vivo in an established mouse model of PJI and, if so, whether this effect can be reversed by preoperative 25D3 supplementation. METHODS: Mice (lys-EGFP) possessing fluorescent neutrophils were fed a vitamin D3-sufficient (n = 20) or deficient (n = 40) diet for 6 weeks...
October 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29033158/revision-total-knee-arthroplasty-for-periprosthetic-joint-infection-is-associated-with-increased-postoperative-morbidity-and-mortality-relative-to-noninfectious-revisions
#4
Venkat Boddapati, Michael C Fu, David J Mayman, Edwin P Su, Peter K Sculco, Alexander S McLawhorn
BACKGROUND: Periprosthetic joint infection (PJI) after primary total knee arthroplasty (TKA) is a devastating complication. The short-term morbidity profile of revision TKA performed for PJI relative to non-PJI revisions is poorly characterized. The purpose of this study is to determine 30-day postoperative outcomes after revision TKA for PJI, relative to primary TKA and aseptic revision TKA. METHODS: The American College of Surgeons National Surgical Quality Improvement Program from 2005 to 2015 was queried for primary and revision TKA cases...
September 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29020266/propionibacterium-avidum-a-virulent-pathogen-causing-hip-periprosthetic-joint-infection
#5
Yvonne Achermann, Jared Liu, Reinhard Zbinden, Patrick O Zingg, Alexia Anagnostopoulos, Emma Barnard, Reto Sutter, Huiying Li, Andrew McDowell, Annelies S Zinkernagel
Background: Propionibacteria are important members of the human skin microbiota, but are also opportunistic pathogens associated with periprosthetic joint infections (PJI). While the role of Propionibacterium acnes in PJI has been widely described, insight into the capacity of Propionibacterium avidum to cause PJI is limited. Methods: An unusual cluster of four hip PJIs caused by P. avidum in one orthopedic center in 2015 prompted us to retrospectively identify and analyze clinical data related to previous P...
August 2, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28988303/high-performance-of-%C3%AE-defensin-lateral-flow-assay-synovasure-in-the-diagnosis-of-chronic-knee-prosthetic-infections
#6
Giovanni Balato, Vincenzo Franceschini, Tiziana Ascione, Alfredo Lamberti, Michele D'Amato, Andrea Ensini, Andrea Baldini
PURPOSE: This prospective study was undertaken to evaluate the diagnostic accuracy of the Synovasure™ α-defensin lateral flow assay to detect or exclude infection and to compare it to the sensitivity and specificity of other diagnostic criteria according to the International Consensus Group on Periprosthetic Joint Infection (PJI). METHODS: All patients who have undergone revision total knee arthroplasty (TKA) from September 2015 to July 2016 were included: 16 chronic (more than 3 months after performing arthroplasty) infections and 35 aseptic joints were identified...
October 7, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28983865/performance-of-automated-multiplex-pcr-using-sonication-fluid-for-diagnosis-of-periprosthetic-joint-infection-a-prospective-cohort
#7
Nora Renz, Susanne Feihl, Sabrina Cabric, Andrej Trampuz
PURPOSE: Sonication of explanted prostheses improved the microbiological diagnosis of periprosthetic joint infections (PJI). We evaluated the performance of automated multiplex polymerase chain reaction (PCR) using sonication fluid for the microbiological diagnosis of PJI. METHODS: In a prospective cohort using uniform definition criteria for PJI, explanted joint prostheses were investigated by sonication and the resulting sonication fluid was analyzed by culture and multiplex PCR...
October 5, 2017: Infection
https://www.readbyqxmd.com/read/28983214/factors-associated-with-choice-and-success-of-one-versus-two-stage-revision-arthroplasty-for-infected-hip-and-knee-prostheses
#8
Lucas Castellani, Nick Daneman, Samira Mubareka, Richard Jenkinson
BACKGROUND: Prosthetic joint infections (PJI) of hip and knee arthroplasties are becoming increasingly common with an aging population and an increasing demand for these procedures. Despite attempts at standardization, medical and surgical approaches vary widely among practitioners. QUESTIONS/PURPOSES: We first sought to determine if there were specific factors associated with choice of one- versus two-stage revision. Then we investigated whether the type of revision approach influenced clinical treatment success...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28971508/current-review-the-rise-of-bacteriophage-as-a-unique-therapeutic-platform-in-treating-peri-prosthetic-joint-infections
#9
REVIEW
Zarique Z Akanda, Mariam Taha, Hesham Abdelbary
Peri-prosthetic joint infection (PJI) is one of the most serious and dreaded complications after total joint replacement (TJR). Due to an aging population and the constant rise in demand for TJR, the incidence of PJI is also increasing. Successful treatment of PJI is challenging and is associated with high failure rates. One of the main causes for treatment failure is bacterial biofilm formation on implant surfaces and the adherence of biofilm bacteria on tissue and bone next to the implant. Biofilms are protective shields to bacterial cells and possess many unique properties that leads to antibiotic resistance...
October 2, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28963626/diagnostic-accuracy-of-alpha-defensin-in-periprosthetic-joint-infection-a-systematic-review-and-meta-analysis
#10
REVIEW
Jun Yuan, Yufei Yan, Jiong Zhang, Bibo Wang, Jianmin Feng
BACKGROUND: Alpha-defensin, a novel biomarker, has shown great potential for the accurate diagnosis of periprosthetic joint infection (PJI) in recent years: many published studies have presented encouraging results. Nevertheless, the diagnostic accuracy of alpha-defensin is inconsistent across published studies. Moreover, the optimum value of the diagnostic threshold urgently needs to be ascertained. This meta-analysis sought to estimate the precision of alpha-defensin for the diagnosis of PJI and, where possible, to confirm the threshold...
September 30, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28958659/risk-factors-for-repeat-debridement-spacer-retention-amputation-arthrodesis-and-mortality-after-removal-of-an-infected-total-knee-arthroplasty-with-spacer-placement
#11
Jourdan M Cancienne, Victor A Granadillo, Kishan J Patel, Brian C Werner, James A Browne
BACKGROUND: Chronic periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) is most commonly addressed with a 2-stage exchange procedure. The purpose of this study is to examine the natural history of patients who have undergone prosthesis removal and spacer placement and evaluate risk factors for outcomes other than reimplantation. METHODS: Patients who underwent removal of an infected TKA and placement of an antibiotic spacer for PJI were identified in a Medicare database...
September 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28939030/positive-blood-cultures-in-periprosthetic-joint-infection-decrease-rate-of-treatment-success
#12
Mitchell R Klement, Ahmed Siddiqi, Justin M Rock, Antonia F Chen, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Blood cultures are often obtained at the time of periprosthetic joint infection (PJI) diagnosis yet they are not considered part of the diagnostic criteria and the effects of a positive result on surgical outcome are unknown. The purposes of this study are to characterize the use of blood cultures when diagnosing PJI and to determine the association of positive blood cultures with PJI treatment success. METHODS: A retrospective chart review on 320 patients surgically treated for primary hip and knee PJIs was performed from 2006-2013 at 2 academic medical centers with minimum 12-month follow-up...
September 4, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28932957/fluoroscopy-vs-ultrasound-guided-aspiration-techniques-in-the-management-of-periprosthetic-joint-infection-which-is-the-best
#13
Filippo Randelli, Marco Brioschi, Pietro Randelli, Federico Ambrogi, Silvana Sdao, Alberto Aliprandi
BACKGROUND: Fluid samples obtained from an affected joint still play a central role in the diagnosis of periprosthetic joint infection (PJI). It is the only preoperative test able to discover the causative microbiological agent. In the hip, fluid aspiration can be performed through fluoroscopy, ultrasound, or, less commonly, computed tomography. However, there is still a lack of consensus on which method is preferable in terms of efficacy and costbenefit. PURPOSES: We, therefore, asked whether (1) the benefits in terms of sensitivity and specificity and (2) the costs were comparable between fluoroscopy- and ultrasound-guided joint aspirations in a suspicious of hip PJI...
September 20, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28912417/comparison-of-leukocyte-esterase-testing-of-synovial-fluid-with-synovial-histology-for-the-diagnosis-of-periprosthetic-joint-infection
#14
Rui Li, Xiang Li, Baozhan Yu, Xin Li, Xinggui Song, Heng Li, Chi Xu, Jiying Chen
BACKGROUND Periprosthetic joint infection (PJI) is a complication of total joint arthroplasty (TJA). The leukocyte esterase (LE) strip test and histology are diagnostic methods for PJI. The aims of this study were to determine the sensitivity and specificity of the LE strip test and to compare it with histology in the diagnosis of PJI. MATERIAL AND METHODS Between January and December 2015, 93 patients who underwent TJA with PJI were enrolled in the study. Synovial fluid samples were tested with an LE strip, and three synovial tissue samples from each patient underwent frozen section and formalin-fixed histology...
September 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28899592/the-american-college-of-surgeons-national-surgical-quality-improvement-program-surgical-risk-calculator-has-a-role-in-predicting-discharge-to-post-acute-care-in-total-joint-arthroplasty
#15
Daniel E Goltz, Billy T Baumgartner, Cary S Politzer, Marcus DiLallo, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Patient demand and increasing cost awareness have led to the creation of surgical risk calculators that attempt to predict the likelihood of adverse events and to facilitate risk mitigation. The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator is an online tool available for a wide variety of surgical procedures, and has not yet been fully evaluated in total joint arthroplasty. METHODS: A single-center, retrospective review was performed on 909 patients receiving a unilateral primary total knee (496) or hip (413) arthroplasty between January 2012 and December 2014...
August 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28882962/prospective-analysis-of-a-sterile-semi-automated-tissue-biopsy-homogenization-method-in-the-diagnosis-of-prosthetic-joint-infections
#16
Christian Suren, Norbert Harrasser, Florian Pohlig, Ingo J Banke, Ulrich Lenze, Florian Lenze, Carolin Knebel, Rüdiger VON Eisenhart-Rothe, Johannes Schauwecker, Heinrich M L Mühlhofer
BACKGROUND/AIM: Prosthetic joint infection (PJI) remains a serious complication of total joint arthroplasty. To effectively treat PJI, it is essential to identify the microorganism causing it and be able to combine correct surgical and anti-infective treatments. This cannot always be achieved with the currently employed diagnostic methods. The aim of this study was to evaluate a semi-automated tissue biopsy bead milling method (Ultra-TurrAX, Axonlab AG; Reichenbach, Germany) based on the hypothesis that the results are more sensitive for microbe detection and less prone to contamination...
September 2017: In Vivo
https://www.readbyqxmd.com/read/28878512/comparison-of-postoperative-complications-after-total-hip-arthroplasty-among-patients-receiving-aspirin-enoxaparin-warfarin-and-factor-xa-inhibitors
#17
Perez Agaba, Beau J Kildow, Herman Dhotar, Thorsten M Seyler, Michael Bolognesi
Optimal prophylaxis for prevention of venous thromboembolism (VTE) after total joint arthroplasty (TJA) remains debated. The purpose of this study was to compare postoperative complications in patients receiving different VTE chemoprophylactic regimens. Using a nationwide healthcare database, 72,670 THA patients without a history of VTE were identified. Study cohorts received VTE prophylaxis within 30 days postoperatively. Odds ratios and 95% confidence intervals were used to assess 30-day and 90-day postoperative complications (hematoma, hemorrhage, transfusion, pulmonary embolism (PE), VTE, prosthetic joint infection (PJI), and incision/drainage (I&D))...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28876459/antibiotic-elution-from-acrylic-bone-cement-loaded-with-high-doses-of-tobramycin-and-vancomycin
#18
Joshua Slane, Bradley Gietman, Matthew Squire
Two-stage revision treatment of prosthetic joint infection (PJI) frequently employs the use of a temporary bone cement spacer loaded with multiple antibiotic types. Tobramycin and vancomycin are commonly used antibiotics in cement spacers, however, there is no consensus on the relative concentrations and combinations that should be used. Therefore, the purpose of this study was to investigate the influence of dual antibiotic loading on the total antibiotic elution and compressive mechanical properties of acrylic bone cement...
September 6, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28874245/prosthetic-joint-infection-following-total-hip-arthroplasty-incidence-mortality-and-validation-of-the-diagnosis-in-the-danish-hip-arthroplasty-register
#19
Per Hviid Gundtoft
Prosthetic joint infection (PJI) is a rare, but devastating complication following primary total hip arthroplasty (THA). As PJI is a rare event, large cohorts of patients are required in order to study this complication. National arthroplasty registers offer such large and unselected cohorts, but studies have shown that these registers - used alone - underestimate the incidence of PJI. The aim of this thesis was to estimate the incidence of PJI and the mortality risk following a PJI by combining data from the Danish Hip Arthroplasty Register (DHR), the National Register of Patients (NRP), the Microbiology Databases, the Civil Registration System, the medical records, the Danish National Prescription Registry and the Clinical Biochemistry Databases...
September 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28872523/serum-d-dimer-test-is-promising-for-the-diagnosis-of-periprosthetic-joint-infection-and-timing-of-reimplantation
#20
Alisina Shahi, Michael M Kheir, Majd Tarabichi, Hamid R S Hosseinzadeh, Timothy L Tan, Javad Parvizi
BACKGROUND: Despite the availability of a battery of tests, the diagnosis of periprosthetic joint infection (PJI) continues to be challenging. Serum D-dimer assessment is a widely available test that detects fibrinolytic activities that occur during infection. We hypothesized that patients with PJI may have a high level of circulating D-dimer and that the presence of a high level of serum D-dimer may be a sign of persistent infection in patients awaiting reimplantation. METHODS: This prospective study was initiated to enroll patients undergoing primary and revision arthroplasty...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
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