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https://www.readbyqxmd.com/read/28526565/efficacy-of-indefinite-chronic-oral-antimicrobial-suppression-for-prosthetic-joint-infection-in-the-elderly-a-comparative-study
#1
V Prendki, P Sergent, A Barrelet, E Oziol, E Beretti, M Berlioz-Thibal, F Bouchand, F Dauchy, E Forestier, G Gavazzi, C Ronde-Oustau, J Stirnemann, A Dinh
OBJECTIVES: During prosthetic joint infection (PJI), surgical management is sometimes impossible, indefinite chronic oral antimicrobial suppression (ICOAS) may sometimes be the only option. We evaluated the outcome of elderly patients who benefited from ICOAS for a strictly palliative goal METHODS: We performed a national retrospective cohort study in France of patients aged >75years old with PJI, and managed with ICOAS planned for life long from 2009 to 2014, and compared the population with an event versus the population free of event...
May 16, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28526202/capnocytophaga-canimorsus-an-underestimated-cause-of-periprosthetic-joint-infection
#2
Marcel Orth, Patrick Orth, Konstantinos Anagnostakos
BACKGROUND: Periprosthetic joint infection (PJI) is a major clinical problem in orthopedic surgery. Capnocytophaga canimorsus (C. canimorsus) is an unusual and hardly detectable bacterium. A review of the literature indicates that C. canimorsus affects mainly immunocompromised patients. It has not been reported to cause periprosthetic joint infections in immunocompetent patients so far. This case report aims to raise awareness of C. canimorsus in orthopedic surgery with special regard to joint arthroplasty...
May 16, 2017: Knee
https://www.readbyqxmd.com/read/28516223/two-stage-revision-hip-arthroplasty-in-periprosthetic-joint-infection-comparison-study-with-or-without-the-use-of-a-spacer
#3
Dariusz Marczak, Marek Synder, Marcin Sibiński, Michał Polguj, Julian Dudka, Jacek Kowalczewski
PURPOSE: The aim of this study was to compare two methods of two-stage surgery for PJI (periprosthetic joint infection) after THA (total hip arthroplasty): one with and one without the use of an antibiotic-loaded cement spacer. METHODS: This retrospective study was performed on 99 consecutive patients (99 hips) with a minimum follow-up of 24 months. Patients were divided into two groups: (1) in whom the operation was performed using a spacer, and (2) for whom a spacer was not used...
May 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28490492/molecular-diagnosis-of-orthopaedic-device-infection-direct-from-sonication-fluid-by-metagenomic-sequencing
#4
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
#5
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/28483043/diagnosis-of-prosthetic-joint-infection-cultures-biomarker-and-criteria
#6
REVIEW
Eric O Gomez-Urena, Aaron J Tande, Douglas R Osmon, Elie F Berbari
Prosthetic joint infections (PJIs) are devastating complications after joint arthroplasty that continue to pose a diagnostic challenge. Currently, a single, stand-alone test with the adequate accuracy and reliability for diagnosis of PJI is not available; therefore, physicians who care for patients with PJI must rely on a combination of diagnostic tests for the diagnosis of PJI. This article reviews conventional laboratory test modalities, diagnostic accuracy and limitations of current tests, and novel emerging tests for the diagnosis of PJI...
June 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28479056/utility-of-synovial-white-blood-cell-count-and-differential-before-reimplantation-surgery
#7
Benjamin M Zmistowski, Corey T Clyde, Elie S Ghanem, James R Gotoff, Carl A Deirmengian, Javad Parvizi
BACKGROUND: Determining optimal timing of reimplantation during 2-stage exchange for periprosthetic joint infection (PJI) remains elusive. Joint aspiration for synovial white blood cell (WBC) count and neutrophil percentage (PMN%) before reimplantation is widely performed; yet, the implications are rarely understood. Therefore, this study investigates (1) the diagnostic yield of synovial WBC count and differential analysis and (2) the calculated thresholds for persistent infection. METHODS: Institutional PJI databases identified 129 patients undergoing 2-stage exchange arthroplasty who had joint aspiration before reimplantation between February 2005 and May 2014...
April 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28473963/rank-ligand-and-osteoprotegerin-as-biomarkers-in-the-differentiation-between-periprosthetic-joint-infection-and-aseptic-prosthesis-loosening
#8
Max J Friedrich, Matthias D Wimmer, Jan Schmolders, Andreas C Strauss, Milena M Ploeger, Hendrik Kohlhof, Dieter C Wirtz, Sascha Gravius, Thomas M Randau
AIM: To assess serum levels of RANK-ligand (RANKL) and osteoprotegerin (OPG) as biomarkers for periprosthetic joint infection (PJI) and compare their accuracy with standard tests. METHODS: One hundred and twenty patients presenting with a painful total knee or hip arthroplasty with indication for surgical revision were included in this prospective clinical trial. Based on standard diagnostics (joint aspirate, microbiological, and histological samples) and Musculoskeletal Infection Society consensus classification, patients were categorized into PJI, aseptic loosening, and control groups...
April 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28473693/serum-and-synovial-fluid-interleukin-6-for-the-diagnosis-of-periprosthetic-joint-infection
#9
Kai Xie, Kerong Dai, Xinhua Qu, Mengning Yan
A gold standard for diagnosis of periprosthetic joint infection (PJI) has not yet been established. The objective of this study was to evaluate the diagnostic value of serum and synovial fluid interleukin (IL)-6 levels for PJI. The MEDLINE and EMBASE databases were searched for studies describing PJI diagnosis using serum and synovial fluid IL-6 and published between January 1990 and October 2016. Seventeen studies were included in the analysis. The pooled sensitivities of serum and synovial fluid IL-6 were 0...
May 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28464821/clindamycin-rifampin-combination-therapy-for-staphylococcal-periprosthetic-joint-infections-a-retrospective-observational-study
#10
Borg Leijtens, Joris B W Elbers, Patrick D Sturm, Bart Jan Kullberg, Berend W Schreurs
BACKGROUND: Staphylococcal species account for more than 50% of periprosthetic joint infections (PJI) and antimicrobial therapy with rifampin-based combination regimens has been shown effective. The present study evaluates the safety and efficacy of clindamycin in combination with rifampin for the management of staphylococcal PJI. METHODS: In this retrospective cohort study, patients were included who received clindamycin-rifampin combination therapy to treat a periprosthetic hip or knee infection by Staphylococcus aureus or coagulase-negative staphylococci...
May 2, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28463919/synovial-fluid-cell-count-for-diagnosis-of-chronic-periprosthetic-hip-infection
#11
Carlos A Higuera, Benjamin Zmistowski, Tennison Malcom, Wael K Barsoum, Scott M Sporer, Philipp Mommsen, Daniel Kendoff, Craig J Della Valle, Javad Parvizi
BACKGROUND: There is a paucity of data regarding the threshold of synovial fluid white blood-cell (WBC) count and polymorphonuclear cell (neutrophil) percentage of the WBC count (PMN%) for the diagnosis of chronic periprosthetic joint infection (PJI) after total hip arthroplasty. Despite this, many organizations have provided guidelines for the diagnosis of PJI that include synovial fluid WBC count and PMN%. We attempted to define a threshold for synovial fluid WBC count and PMN% for the diagnosis of chronic PJI of the hip using a uniform definition of PJI and to investigate any variations in the calculated thresholds among institutions...
May 3, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28461965/total-knee-arthroplasty-and-infection-how-surgeons-can-reduce-the-risks
#12
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/28461959/the-role-of-biomarkers-in-the-diagnosis-of-periprosthetic-joint-infection
#13
AliSina Shahi, Javad Parvizi
The role of serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) as the first line for evaluating a patient with periprosthetic joint infection (PJI) has been debunked.We are living in the era of biomarkers for the diagnosis of PJI, and to that effect, several biomarkers have been introduced such as synovial fluid alpha defensin and leukocyte esterase.The synovial fluid leukocyte esterase test has a low cost, is accessible, and has provided promising results for diagnosing PJI.There is an urgent need for an accurate and reliable serum biomarker for diagnosing patients with PJI...
July 2016: EFORT Open Rev
https://www.readbyqxmd.com/read/28456562/withholding-preoperative-antibiotic-prophylaxis-in-knee-prosthesis-revision-a-retrospective-analysis-on-culture-results-and-risk-of-infection
#14
Marjan Wouthuyzen-Bakker, Eduard Tornero, Guillem Claret, Jordi Bosch, Juan Carlos Martinez-Pastor, Andreu Combalia, Alex Soriano
BACKGROUND: A significant amount of patients undergoing revision surgery of a prosthetic joint turn out to have an infection. Withholding preoperative antibiotic prophylaxis in these patients to optimize culture yield during revision surgery remains a matter of debate. The aim of our study was to determine (1) the rate of positive intraoperative cultures with or without preoperative antibiotic prophylaxis and (2) the incidence of a prosthetic joint infection (PJI) during the follow-up in the 2 groups...
April 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28456558/removal-of-an-infected-total-hip-arthroplasty-risk-factors-for-repeat-debridement-long-term-spacer-retention-and-mortality
#15
Jourdan M Cancienne, Brian C Werner, Surajudeen A Bolarinwa, James A Browne
BACKGROUND: Two-stage exchange arthroplasty remains the preferred approach to treatment of chronic periprosthetic joint infection (PJI) following total hip arthroplasty (THA). The objective of the present study is to investigate the fate of antibiotic spacers placed for periprosthetic joint infection after THA and evaluate risk factors for outcomes other than reimplantation. METHODS: A national database was queried for Medicare patients who underwent removal of an infected hip prosthesis and placement of an antibiotic spacer...
March 30, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28455476/synovial-calprotectin-a-potential-biomarker-to-exclude-a-prosthetic-joint-infection
#16
M Wouthuyzen-Bakker, J J W Ploegmakers, G A Kampinga, L Wagenmakers-Huizenga, P C Jutte, A C Muller Kobold
AIMS: Recently, several synovial biomarkers have been introduced into the algorithm for the diagnosis of a prosthetic joint infection (PJI). Alpha defensin is a promising biomarker, with a high sensitivity and specificity, but it is expensive. Calprotectin is a protein that is present in the cytoplasm of neutrophils, is released upon neutrophil activation and exhibits anti-microbial activity. Our aim, in this study, was to determine the diagnostic potential of synovial calprotectin in the diagnosis of a PJI...
May 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28455475/high-failure-rates-in-treatment-of-streptococcal-periprosthetic-joint-infection-results-from-a-seven-year-retrospective-cohort-study
#17
D Akgün, A Trampuz, C Perka, N Renz
AIMS: To investigate the outcomes of treatment of streptococcal periprosthetic joint infection (PJI) involving total knee and hip arthroplasties. PATIENTS AND METHODS: Streptococcal PJI episodes which occurred between January 2009 and December 2015 were identified from clinical databases. Presentation and clinical outcomes for 30 streptococcal PJIs in 30 patients (12 hip and 18 knee arthroplasties) following treatment were evaluated from the medical notes and at review...
May 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28455474/contemporary-failure-aetiologies-of-the-primary-posterior-stabilised-total-knee-arthroplasty
#18
M P Abdel, C K Ledford, A Kobic, M J Taunton, A D Hanssen
AIMS: The number of revision total knee arthroplasties (TKA) that are performed is expected to increase. However, previous reports of the causes of failure after TKA are limited in that they report the causes at specific institutions, which are often dependent on referral patterns. Our aim was to report the most common indications for re-operations and revisions in a large series of posterior-stabilised TKAs undertaken at a single institution, excluding referrals from elsewhere, which may bias the causes of failure...
May 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28455470/functional-outcome-of-debridement-antibiotics-and-implant-retention-in-periprosthetic-joint-infection-involving-the-hip-a-case-control-study
#19
G Grammatopoulos, M-E Bolduc, B L Atkins, B J L Kendrick, P McLardy-Smith, D W Murray, R Gundle, A H Taylor
AIMS: Advocates of debridement, antibiotics and implant retention (DAIR) in hip periprosthetic joint infection (PJI) argue that a procedure not disturbing a sound prosthesis-bone interface is likely to lead to better survival and functional outcome compared with revision. This case-control study aims were to compare outcome of DAIRs for infected primary total hip arthroplasty (THA) with outcomes following primary THA and two-stage revision of infected primary THAs. PATIENTS AND METHODS: We retrospectively reviewed all DAIRs, performed for confirmed infected primary hip arthropasty (n = 82) at out institution, between 1997 and 2013...
May 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28454760/tropism-and-virulence-of-cutibacterium-formerly-propionibacterium-acnes-involved-in-implant-associated-infection
#20
Guillaume Ghislain Aubin, Jean-Philippe Lavigne, Yohan Foucher, Sarah Dellière, Didier Lepelletier, François Gouin, Stéphane Corvec
The recognition of the pathogenicity of Cutibacterium acnes in implant-associated infection is not always obvious. In this paper, we aimed to distinguish pathogenic and non-pathogenic C. acnes isolates. To reach this goal, we investigated the clonal complex (CC) of a large collection of C. acnes clinical isolates through Multi-Locus Sequence Typing (MLST), we established a Caenorhabditis elegans model to assess C. acnes virulence and we investigated the presence of virulence factors in our collection. Ours results showed that CC36 and CC53 C...
April 25, 2017: Anaerobe
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