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https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#1
Rares Mircea Birlutiu, Mihai Dan Roman, Razvan Silviu Cismasiu, Sorin Radu Fleaca, Crina Maria Popa, Manuela Mihalache, Victoria Birlutiu
BACKGROUND: In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic...
July 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28714050/superiority-of-the-sonication-method-against-conventional-periprosthetic-tissue-cultures-for-diagnosis-of-prosthetic-joint-infections
#2
Sofia Tani, Panagiotis Lepetsos, Antonios Stylianakis, John Vlamis, Konstantinos Birbas, Ioannis Kaklamanos
INTRODUCTION: Diagnosis of periprosthetic infections is challenging. The aim of this study was to compare the diagnostic accuracy of conventional periprosthetic tissue culture and culture of sonication fluid of the explanted prostheses. METHODS: We prospectively enrolled 114 patients undergoing revision hip or knee arthroplasty because of loosening of the prostheses, at our institution, between July 2012 and July 2016. Patients' medical history and demographic characteristics were recorded...
July 17, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28713524/forced-air-warming-discontinued-periprosthetic-joint-infection-rates-drop
#3
REVIEW
Scott D Augustine
Several studies have shown that the waste heat from forced-air warming (FAW) escapes near the floor and warms the contaminated air resident near the floor. The waste heat then forms into convection currents that rise up and contaminate the sterile field above the surgical table. It has been shown that a single airborne bacterium can cause a periprosthetic joint infection (PJI) following joint replacement surgery. We retrospectively compared PJI rates during a period of FAW to a period of air-free conductive fabric electric warming (CFW) at three hospitals...
June 23, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28712799/diagnosing-periprosthetic-joint-infection-and-the-winner-is
#4
Alisina Shahi, Timothy L Tan, Michael M Kheir, Dean D Tan, Javad Parvizi
BACKGROUND: Diagnosis of periprosthetic joint infection (PJI) remains a challenge despite a wide variety of available diagnostic tests. The question that arises is which of these tests has a better performance for diagnosing PJI. Diagnostic odds ratio (DOR) has been described as the best indicator for test performance. METHODS: To compare the performance of the standard diagnostic tests, the DOR of serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), synovial fluid (SF) white blood cell (WBC) count, SF polymorphonuclear (PMN%), and leukocyte esterase (LE) were calculated...
June 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28708567/%C3%AE-defensin-point-of-care-test-for-diagnosis-of-prosthetic-joint-infections-neglected-role-of-laboratory-and-clinical-pathologists
#5
REVIEW
Lorenzo Drago, Marco Toscano, Lorenza Tacchini, Giuseppe Banfi
Periprosthetic joint infection (PJI) is a serious complication that may occur after native joint replacement leading to a severe health and economic burden. Currently, due to several confounding factors, PJI is difficult to diagnose. Today, a multidisciplinary approach is indispensable to correctly define a periprosthetic joint infection; indeed, tissue histology, microbiology cultures and clinical findings are used together to achieve this goal. Analysis of α-defensin is commonly used for PJI diagnosis, as it allows the rapid detection of α-defensin present in the synovial fluid following a microbial infection...
July 14, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28706395/salmonella-typhimurium-infection-in-total-knee-arthroplasty-a-case-report-with-review-of-literature
#6
Sujeesh Sebastian, Benu Dhawan, Rajesh Malhotra, Deepak Gautam, Arti Kapil
Salmonella enterica serotype Typhimurium is a rare cause of prosthetic joint infection (PJI). The recognized predisposing risk factors for Salmonella septic arthritis include diabetes mellitus, renal failure, human immunodeficiency virus infection and chronic corticosteroid use. We describe a case of PJI of the knee in a 74-year-old lady who was on antitubercular treatment. The patient presented with discharging sinus and raised inflammatory markers. She was successfully treated by the removal of prosthesis and debridement followed by ciprofloxacin therapy for 6 weeks...
July 2017: Journal of Laboratory Physicians
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
#7
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/28690466/propionibacterium-acnes-host-inflammatory-response-during-periprosthetic-infection-is-joint-specific
#8
Scott R Nodzo, K Keely Boyle, Samrath Bhimani, Thomas R Duquin, Andy O Miller, Geoffrey H Westrich
BACKGROUND: Propionibacterium acnes (P. acnes) has become increasingly recognized as a cause of periprosthetic joint infection (PJI). QUESTIONS/PURPOSES: It is not currently known if the clinical presentation of P. acnes varies depending on the joint being infected. METHODS: We retrospectively reviewed patients infected with P. acnes after total hip, knee, and shoulder arthroplasty from two institutions. Patients were classified as having a PJI based on the Musculoskeletal Infection Society criteria and were excluded if they had a polymicrobial culture...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28686144/synovial-fluid-%C3%AE-defensin-as-a-biomarker-for-peri-prosthetic-joint-infection-a-systematic-review-and-meta-analysis
#9
Bin Li, Fei Chen, Yi Liu, Guokang Xu
BACKGROUND: Total joint arthroplasty (TJA) has been one of the most beneficial interventions for treating patients suffering from joint disorders. However, peri-prosthetic joint infection (PJI) is a serious complication that often accompanies TJA and the diagnosis of PJI is remains difficult. Questions remain regarding whether certain biomarkers can be valuable in the diagnosis of PJI. PATIENTS AND METHODS: We conducted our systematic review by searching PubMed, Embase, Web of Science, the Cochrane Library, and Science Direct with the key words "periprosthetic joint infection," "synovial fluid," and "α-defensin...
July 7, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28668678/moxifloxacin-plus-rifampin-as-an-alternative-for-levofloxacin-plus-rifampin-in-the-treatment-of-a-prosthetic-joint-infection-with-staphylococcus-aureus
#10
Marjan Wouthuyzen-Bakker, Eduard Tornero, Laura Morata, Prashant V Nannan Panday, Paul C Jutte, Guillem Bori, Greetje A Kampinga, Alex Soriano
OBJECTIVES: The combination of a fluorquinolone with rifampin is one of the cornerstones in the treatment of a prosthetic joint infection (PJI) caused by staphylococci. Moxifloxacin is highly active against methicillin susceptible S. aureus (MSSA), and therefore, an attractive agent to use. However, several studies reported a lowering in serum moxifloxacin levels when combined with rifampin. The clinical relevance remains unclear. We determined the outcome of patients with an early acute PJI caused by MSSA treated either with moxifloxacin/rifampin or levofloxacin/rifampin...
June 28, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28662955/determining-the-threshold-for-hba1c-as-a-predictor-for-adverse-outcomes-after-total-joint-arthroplasty-a-multicenter-retrospective-study
#11
Majd Tarabichi, Noam Shohat, Michael M Kheir, Muyibat Adelani, David Brigati, Sean M Kearns, Pankajkumar Patel, John C Clohisy, Carlos A Higuera, Brett R Levine, Ran Schwarzkopf, Javad Parvizi, William A Jiranek
BACKGROUND: Although HbA1c is commonly used for assessing glycemic control before surgery, there is no consensus regarding its role and the appropriate threshold in predicting adverse outcomes. This study was designed to evaluate the potential link between HbA1c and subsequent periprosthetic joint infection (PJI), with the intention of determining the optimal threshold for HbA1c. METHODS: This is a multicenter retrospective study, which identified 1645 diabetic patients who underwent primary total joint arthroplasty (1004 knees and 641 hips) between 2001 and 2015...
May 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28659322/the-effect-of-preoperative-antimicrobial-prophylaxis-on-intraoperative-culture-results-in-patients-with-a-suspected-or-confirmed-prosthetic-joint-infection-a-systematic-review
#12
Marjan Wouthuyzen-Bakker, Natividad Benito, Alex Soriano
Introduction: Obtaining reliable cultures during revision arthroplasty is important to adequately diagnose and treat a prosthetic joint infection (PJI). The influence of antimicrobial prophylaxis on culture results remains unclear. As withholding prophylaxis increases the risk for surgical site infections, clarification on this topic is critical.Material and methods: A systematic review was performed with the following research question: 'In patients who undergo revision surgery of a prosthetic joint (P), does preoperative antimicrobial prophylaxis (I) affect the culture yield (O) of intraoperative samples in comparison with non-preoperative antimicrobial prophylaxis (C)?'Results: 7 articles were included in the final analysis...
June 28, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28657567/bone-scan-in-painful-knee-arthroplasty-obsolete-or-actual-examination
#13
Giuseppe Niccoli, Domenico Mercurio, Fabrizio Cortese
ptic loosening, instability and infection are the major causes of TKA failure. For many years, nuclear medicine (NM) imaging was helpful to frame a painful total joint arthroplasty. The differentiation of septic from aseptic prosthetic loosening is critical. The latest AAOS guidelines to detect periprosthetic joint infection (PJI) restrict the role of NM scintigraphy. On the other hand, several studies suggest that NM imaging plays an important role in the evaluation of patients with painful prosthesis, but its specificity in differentiating aseptic loosening from infection is low...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28652437/increased-resistance-of-skin-flora-to-antimicrobial-prophylaxis-in-patients-undergoing-hip-revision-arthroplasty
#14
Heinrich M L Mühlhofer, Lukas Deiss, Philipp Mayer-Kuckuk, Florian Pohlig, Norbert Harrasser, Ulrich Lenze, Hans Gollwitzer, Christian Suren, Peter Prodinger, Rüdiger VON Eisenhart-Rothe, Johannes Schauwecker
BACKGROUND/AIM: Prosthetic joint infection (PJI) remains a major complication after total joint replacement and is the primary indication for revision arthroplasty. Specifically, coagulase-negative Staphylococci (CNS) can cause low-grade infections. Despite the use of cephalosporin-based antimicrobial prophylaxis (AMP) and antiseptic treatment at the surgical site, evidence suggests that a significant number of cases of dermal CNS results in low-grade PJI. Thus, this study examined the bacterial colonization and resistance patterns at the surgical site...
July 2017: In Vivo
https://www.readbyqxmd.com/read/28646360/does-the-risk-of-rerevision-vary-between-porous-tantalum-cups-and-other-cementless-designs-after-revision-hip-arthroplasty
#15
Inari Laaksonen, Michelle Lorimer, Kirill Gromov, Ola Rolfson, Keijo T Mäkelä, Stephen E Graves, Henrik Malchau, Maziar Mohaddes
BACKGROUND: Earlier results with porous tantalum acetabular cups in revision THA generally have been favorable. Recently there has been some evidence presented that porous tantalum cups might decrease the risk of rerevision in the setting of revision hip surgery performed owing to prosthetic joint infection (PJI). As the data supporting this assertion come from a study with a limited study population, examining this issue with a large registry approach may be enlightening. QUESTIONS/PURPOSES: By combining results from two large, national registries, we asked: (1) Do porous tantalum cups show improved survival after revision THA compared with other cementless designs? (2) Does the use of porous tantalum cups influence survivorship when rerevision for PJI is the endpoint? METHODS: A total of 2442 first-time THA revisions with porous tantalum cups and 4401 first-time revisions with other uncemented cups were included in this collaborative study between the Australian and Swedish national joint registries...
June 23, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28642256/revision-for-prosthetic-joint-infection-following-hip-arthroplasty-evidence-from-the-national-joint-registry
#16
E Lenguerrand, M R Whitehouse, A D Beswick, S A Jones, M L Porter, A W Blom
OBJECTIVES: We used the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) to investigate the risk of revision due to prosthetic joint infection (PJI) for patients undergoing primary and revision hip arthroplasty, the changes in risk over time, and the overall burden created by PJI. METHODS: We analysed revision total hip arthroplasties (THAs) performed due to a diagnosis of PJI and the linked index procedures recorded in the NJR between 2003 and 2014...
June 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28637910/excellent-diagnostic-characteristics-for-ultra-fast-gene-profiling-of-defa1-il1b-ltf-in-the-detection-of-prosthetic-joint-infections
#17
Regina Fillerova, Jiri Gallo, Martin Radvansky, Veronika Kraiczova, Milos Kudelka, Eva Kriegova
The timely and exact diagnosis of prosthetic joint infection (PJI) is crucial for surgical decision-making. Intra-operatively, delivery of the result within an hour is required. Alpha-defensin lateral immunoassay of joint fluid (JF) is precise in the intra-operative exclusion of PJI, however in patients with a limited amount of JF and/or when the JF is bloody this test is unhelpful. Important information is hidden in the periprosthetic tissues that could much better reflect the current status of implant pathology...
June 21, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28623686/temporomandibular-prosthetic-joint-infections-associated-with-propionibacterium-acnes-a-case-series-and-a-review-of-the-literature
#18
Ruba Khader, Joseph Tingey, Steven Sewall
PURPOSE: The orthopedic literature has shown an increasing incidence of prosthetic joint infections (PJIs) associated with Propionibacterium acnes (P acnes). These infections present serious diagnostic and management challenges to the treating surgeons. In this review, the authors report on cases of P acnes-related temporomandibular joint (TMJ) PJIs that have been diagnosed and treated at their institution. MATERIALS AND METHODS: After approval by the institutional review board, information was obtained through a retrospective chart review...
May 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28622842/two-stage-knee-arthrodesis-with-a-modular-intramedullary-nail-due-to-septic-failure-of-revision-total-knee-arthroplasty-with-extensor-mechanism-deficiency
#19
Max J Friedrich, Jan Schmolders, Matthias D Wimmer, Andreas C Strauss, Milena M Ploeger, Dieter C Wirtz, Sascha Gravius, Thomas M Randau
BACKGROUND: Periprosthetic joint infection is a serious complication and reconstruction after failed revision total knee arthroplasty with significant bone loss and compromised soft-tissues can be challenging. Objective of this study was to assess clinical and functional results, implant survival and infection recurrence rates in patients treated with two-stage arthrodesis after failed revision TKA with extensor mechanism deficiencies due to PJI, and to identify the factors that affect outcomes after surgery...
June 13, 2017: Knee
https://www.readbyqxmd.com/read/28611966/periprostetic-joint-infection-caused-by-salmonella-case-reports-of-two-azathioprine-and-prednisolone-induced-immunocompromised-patients
#20
Mehmet Ekinci, Serkan Bayram, Turgut Akgül, Mehmet Ersin, Önder Yazicioğlu
Periprosthetic joint infection (PJI) due to Salmonella is rare. It frequently occurs patients receiving immunosuppressive medicine. We describe two periprosthetic Salmonella infection of two immunocompromised patients. Both of patients were receiving azathioprine and prednisolone therapy. First patient presented six years after total hip arthroplasty with a huge abscess on her right thigh that was reached to femoral component through the lytic area of lateral femur. Second patient presented with drainage from his hip and he had undergone two-step revision surgery for PJI 3 months ago...
June 2017: Hip & Pelvis
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